Document Detail

First trimester aneuploidy screening in the presence of a vanishing twin: implications for maternal serum markers.
MedLine Citation:
PMID:  20066674     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To assess the impact of a vanishing twin on the levels of the biochemical markers used in the first trimester aneuploidy screening. METHODS: A retrospective analysis of free beta-hCG and PAPP-A levels in 270 women with a normal singleton fetus with ultrasound evidence of a vanishing twin pregnancy. Marker levels (as MoM) were compared in three groups-76 women with a second empty gestational sac, 194 women with a second gestational sac containing a dead fetus with a measurable crown rump length (CRL), and 1360 matched singleton pregnancies. RESULTS: In women with a second empty gestational sac, the median free beta-hCG and PAPP-A MoMs (0.968 and 1.040, respectively) were not significantly different from the 1.0 MoM in singleton pregnancies. In the group with a vanished twin with a measurable-CRL-there was a significantly increased median PAPP-A MoM (1.317) but the median free beta-hCG MoM was not changed (1.024). Modelling this bias in PAPP-A MoM the detection rate for trisomy 21 would fall from 85 to 75%. CONCLUSION: First trimester screening in the presence of a vanishing twin may lead to errors in risk estimation. In such circumstances it may be advisable to restrict screening to the use of nuchal translucency (NT) alone.
K Spencer; I Staboulidou; K H Nicolaides
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Prenatal diagnosis     Volume:  30     ISSN:  1097-0223     ISO Abbreviation:  Prenat. Diagn.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-01     Completed Date:  2010-06-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8106540     Medline TA:  Prenat Diagn     Country:  England    
Other Details:
Languages:  eng     Pagination:  235-40     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2009 John Wiley & Sons, Ltd.
Prenatal Screening Unit, Clinical Biochemistry Department, King George Hospital, Goodmayes, UK.
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MeSH Terms
Abortion, Missed / blood*,  ultrasonography
Biological Markers / blood*
Chorionic Gonadotropin, beta Subunit, Human / blood*
Diseases in Twins / blood*,  ultrasonography
Fetal Death / blood*,  ultrasonography
Pregnancy Trimester, First / blood*
Pregnancy-Associated Plasma Protein-A / analysis*
Retrospective Studies
Twins, Dizygotic
Twins, Monozygotic
Reg. No./Substance:
0/Biological Markers; 0/Chorionic Gonadotropin, beta Subunit, Human; EC 3.4.24.-/Pregnancy-Associated Plasma Protein-A

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