The Endocrinology of the Fetoplacental Unit in the Second Trimester of Pregnancy

Chard, Tim; Grudzinskas, J. G.

doi:10.1007/978-1-4471-1802-2_14

Cited by 4 publications

(3 citation statements)

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“…Our study expands the information available on maternal serum markers and ultrasound observations as screening tools for Down's syndrome in the first trimester in a high risk population. PAPP‐A, the single best serum parameter in first trimester reported to date, shows MOM values in Down fetuses ranging between 0.23 and 0.44 MOM in 63 cases 1,4–7,15 . These findings could be confirmed in our studies with a calculated median in the Down's syndrome group of 0.51.…”

Section: Discussionsupporting

confidence: 86%

“…There have been several reports examining the association between maternal biochemical screening parameters and Down's syndrome in the first trimester. Previous investigations have demonstrated that the median value of pregnancy‐associated plasma protein A (PAPP‐A) in the first trimester in Down's syndrome pregnancies was significantly lower than in the normal population 1–5 . For a combination of maternal age and decreased serum PAPP‐A levels a detection rate for Down's syndrome of 62 % for a false positive rate of 5% has been reported; observations on different populations in the first trimester studied in three other centres yielded similar results 6–7 regardless of whether Down's syndrome was diagnosed at chorionic villus sampling (CVS) or at term.…”

Section: Introductionmentioning

confidence: 90%

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Serum parameters and nuchal translucency in first trimester screening for fetal chromosomal abnormalities

Zimmermann

Hucha

Savoldelli

et al. 1996

BJOG

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Objective To assess the relation between serum parameters and nuchal translucency in pregnancies affected by fetal aneuploidy in the first trimester. Design Retrospective study of different serum parameters collected prior to chorionic villus sampling and measurement of nuchal translucency in relation to fetal aneuploidy. Setting Switzerland (German and Italian sector) and Bregenz, Austria. Population One thousand one hundred and fifty‐one women aged 25 to 44 years at 10 to 13 weeks of gestation undergoing chorionic villus sampling, mostly for advanced maternal age. Fetal aneuploidy was found in 23 pregnancies including four cases of trisomy 21, five of trisomy 18 and one case of trisomy 13. Main outcome measure Fetal karyotype, serum levels of free β‐hCG, pregnancy‐associated plasma protein A (PAPP‐A) and alpha‐fetoprotein and the measurement of nuchal translucency. Results Serum PAPP‐A was decreased in all common chromosomal abnormalities. Free β‐hCG levels were increased in trisomy 21 but decreased in trisomy 18, whereas alpha‐fetoprotein was low in trisomy 21, 18 and other chromosomal abnormalities. Nine of twenty‐three abnormal embryos had evidence of an increased nuchal translucency. Nuchal translucency, however, did not seem to be associated with any alteration in the levels of the biochemical parameters in either chromosomally normal or abnormal embryos. A low serum PAPP‐A or an increased nuchal translucency was seen in two‐thirds of all pregnancies with chromosomal abnormalities. Conclusion A nuchal translucency 3 mm and depressed serum PAPP‐A levels have a good predictive value in the detection of fetal aneuploidy at 10 to 13 weeks of pregnancy. Serum free 0‐hCG and alpha‐fetoprotein levels may give additional information. An increased nuchal translucency was not‐associated with altered serum parameters. This would allow these different markers to be used in combination.

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