Does a “vanishing twin” affect first-trimester biochemistry in Down syndrome risk assessment? - 18/08/11
, Sriram C. Perni, MD, Mladen Predanic, MD, MSc, Robin B. Kalish, MD, Frank A. Chervenak, MD
Reprint requests: Stephen T. Chasen, MD, 525 East 68th Street, Room J130, New York, NY 10021.Abstract |
Objective |
The purpose of this study was to evaluate the impact of spontaneous reduction in multifetal pregnancy on first-trimester maternal serum biochemistry.
Study design |
We evaluated first-trimester pregnancy associated plasma protein-A (PAPP-A) and free β-human chorionic gonadotropin levels in singleton euploid pregnancies. Biochemical values in pregnancies with evidence of spontaneous reduction were compared to other singleton pregnancies. Mann-Whitney U, Student t test, Fisher exact test, and logistic regression analysis were used for statistical comparison.
Results |
There were 41 cases (0.9%) of spontaneous reduction. Though spontaneous reduction was not associated with different levels of either analyte, reduction within 4 weeks was associated with higher levels of both PAPP-A (1.79 vs 1.18; P = .002) and free β-hCG (1.28 vs 0.96; P = .03) compared with other pregnancies. Spontaneous reduction was associated with a higher frequency of PAPP-A >95th %ile (17.1 vs 4.7%; P = .003) and free β-hCG >95th %ile (17.1% vs 5.0%; P = .004). Logistic regression identified independent associations between spontaneous reduction and both high PAPP-A and high free β-hCG.
Conclusion |
Recent spontaneous reduction is associated with higher values of PAPP-A and free β-hCG. These differences have the potential to affect risk assessment for fetal aneuploidy.
Le texte complet de cet article est disponible en PDF.Key words : Down syndrome screening, Twin pregnancy, Vanishing twin, Serum screening
Plan
Vol 195 - N° 1
P. 236-239 - juillet 2006 Retour au numéro
Article précédent
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