Document Detail


First-trimester screening in pregnancies conceived by assisted reproductive technology: significance of gestational dating by oocyte retrieval or sonographic measurement of crown-rump length.
MedLine Citation:
PMID:  18816495     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To evaluate, in pregnancies conceived by assisted reproductive technology, whether determination of gestational age (GA) by date of oocyte aspiration (DOA) or crown-rump length (CRL) at first-trimester screening influences the distribution of serum and sonographic markers or the performance of first-trimester screening for chromosomal abnormalities. METHODS: GA was calculated using either DOA or CRL at blood sampling and nuchal translucency thickness (NT) measurement in 729 singleton pregnancies conceived by in-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). Weight-corrected log multiples of the median (MoM) marker distributions specific for IVF pregnancy were established using multiple log regression and compared for DOA- and CRL-based GA calculation. RESULTS: GA determined by CRL was significantly larger, albeit slightly, than was GA determined by DOA, with a mean difference of 1.50 (SD, 2.4) days (P < 0.001). Log MoM distributions of free beta-human chorionic gonadotropin and NT showed that GA dating by CRL resulted in significantly higher, albeit slightly, mean log MoM values compared with DOA dating. The reverse was the case for mean log MoM pregnancy-associated plasma protein-A. The SDs were similar for CRL and DOA dating. According to Monte Carlo simulation, the use of DOA or CRL for GA dating did not appreciably influence the performance of first-trimester screening. CONCLUSIONS: DOA and CRL are practically equivalent when calculating GA for first-trimester screening. The correct method of GA dating for other purposes (e.g. estimated time of delivery) in IVF/ICSI pregnancies is still unresolved.
Authors:
A C Gjerris; A Loft; A Pinborg; A Tabor; M Christiansen
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  32     ISSN:  1469-0705     ISO Abbreviation:  Ultrasound Obstet Gynecol     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-09-30     Completed Date:  2009-03-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  England    
Other Details:
Languages:  eng     Pagination:  612-7     Citation Subset:  IM    
Affiliation:
Department of Fetal Medicine, Copenhagen University Hospital, Copenhagen, Denmark. ac@gjerris.dk
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MeSH Terms
Descriptor/Qualifier:
Adult
Body Weight / physiology
Chorionic Gonadotropin, beta Subunit, Human / metabolism
Chromosome Disorders / diagnosis*
Cohort Studies
Crown-Rump Length*
Female
Gestational Age*
Humans
Oocyte Retrieval*
Pregnancy
Pregnancy Trimester, First
Pregnancy-Associated Plasma Protein-A / metabolism
Prospective Studies
Reproductive Techniques, Assisted*
Sensitivity and Specificity
Ultrasonography, Prenatal / methods*
Chemical
Reg. No./Substance:
0/Chorionic Gonadotropin, beta Subunit, Human; EC 3.4.24.-/Pregnancy-Associated Plasma Protein-A

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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