Association between isolated abnormal levels of maternal serum unconjugated estriol in the second trimester and adverse pregnancy outcomes

AbstractAim:The aim of this study was to evaluate the predictive value of α-fetoprotein in maternal serum (MS-AFP) as a marker for diverse pregnancy outcomes.Methods:The study was based on pregnancy and delivery data from 5520 women between 1999 and 2014 at University Hospital of Zurich (UHZ). Inclusion criteria: both MS-AFP and pregnancy outcome were known for the same pregnancy. Pregnancy outcomes and characteristics such as fetal malformation, intrauterine fetal death (IUFD) and intrauterine growth retardation as well as maternal age, weight before pregnancy, gestational age (GA) at delivery, newborn weight, length and head circumference were analyzed with respect to the MS-AFP value. MS-AFP value was categorized into three groups: elevated MS-AFP>2.5 multiples of the median (MoM), normal 0.5–2.49 MoM and decreased <0.5 MoM.Results:Newborn weight (g) and length (cm) were significantly lower in the elevated MS-AFP (P<0.001) group, and infants had 1 week lower GA at delivery (P<0.05). In the group of elevated MS-AFP (n=46), 26.1% of pregnancies were significantly related to adverse pregnancy outcomes, such as fetal malformations, fetuses small for gestational age (SGA) and IUFD. Adverse pregnancy outcomes of 5.6% were registered in the group of normal MS-AFP and 7.3% in the group of low MS-AFP (P<0.05).Conclusion:MS-AFP level in the second trimester is still an important indicator of fetal surface malformations; however, ultrasound still outweighs as a screening method. Nevertheless, pregnant women with elevated MS-AFP values and with no sonographically detected fetal malformations should additionally receive the third trimester ultrasound examination to exclude other possible complications of pregnancy.

Download Full-text

First and Second-Trimester Maternal Serum Analytes for the Prediction of Adverse Pregnancy Outcomes

Journal of Obstetrics Gynecology and Cancer Research ◽

10.30699/jogcr.6.1.22 ◽

2021 ◽

Vol 6 (1) ◽

pp. 22-28

Author(s):

Mona Taghavipour ◽

Tahereh Galini-Moghaddam ◽

Seyed Jaber Mousavi ◽

◽

...

Keyword(s):

Pregnancy Outcomes ◽

Maternal Serum ◽

Adverse Pregnancy Outcomes ◽

Second Trimester ◽

Adverse Pregnancy

Download Full-text

Clinical significance of unexplained elevated maternal serum alpha feto-protein in second trimester of pregnancy

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20182329 ◽

2018 ◽

Vol 7 (6) ◽

pp. 2245

Author(s):

Urmila Karya ◽

Sweta Kumari ◽

Anupam Rani ◽

Shakun Singh

Keyword(s):

Pregnant Women ◽

Pregnancy Outcome ◽

Pregnancy Outcomes ◽

Predictive Value ◽

Maternal Serum ◽

Adverse Pregnancy Outcomes ◽

Alpha Fetoprotein ◽

Second Trimester ◽

Serum Alpha Fetoprotein ◽

Adverse Pregnancy

Background: Alpha-fetoprotein (AFP) is the major serum protein in the embryonic stage and in the early fetal stage. The aim of this study was to measure maternal serum AFP levels in second trimester between 15-20 weeks of gestation and to determine whether unexplained elevated MSAFP levels is an effective predictor of adverse pregnancy outcome among Indian population.Methods: This study was a prospective observational study, carried out on 400 pregnant women. Maternal serum alpha-fetoprotein (MSAFP) was measured between 15 and 20 weeks of gestation after excluding congenital malformation or birth defects. MSAFP level was determined by using a radio-immunoassay technique. Women with MSAFP level >2.0 MoM was considered as abnormal while MSAFP level≤ 2.0 MoM was considered as normal. All women were followed up till delivery and pregnancy outcomes were noted and compared between two groups.Results: Women with elevated MSAFP had significantly higher adverse pregnancy outcomes (75.4%) compared to women with MSAFP ≤2.0 MoM (26.1%) (p<0.0001 with relative risk of 2.89, 95% confidence interval 2.276 -3.667).Conclusions: Unexplained elevated MSAFP has high sensitivity, specificity, positive predictive value and negative predictive value in predicting adverse pregnancy outcomes. It would, therefore be worthwhile screening pregnant women in second trimester for maternal serum alpha-fetoprotein levels as it would help to identify high risk pregnancies and allow close antenatal survillence for better pregnancy outcome.

Download Full-text

Screening for abnormal placentation and adverse pregnancy outcomes with maternal serum biomarkers in the second trimester

Prenatal Diagnosis ◽

10.1002/pd.4370 ◽

2014 ◽

pp. n/a-n/a ◽

Cited By ~ 2

Author(s):

Katherine R. Goetzinger ◽

Anthony O. Odibo

Keyword(s):

Pregnancy Outcomes ◽

Maternal Serum ◽

Serum Biomarkers ◽

Adverse Pregnancy Outcomes ◽

Second Trimester ◽

Abnormal Placentation ◽

Adverse Pregnancy

Download Full-text

Comparison of pregnancy outcomes after second trimester amniocentesis between procedures performed by experts and non-experts

Journal of Perinatal Medicine ◽

10.1515/jpm-2020-0430 ◽

2020 ◽

Vol 0 (0) ◽

Author(s):

Tanapak Wisetmongkolchai ◽

Fuanglada Tongprasert ◽

Kasemsri Srisupundit ◽

Suchaya Luewan ◽

Kuntharee Traisrisilp ◽

...

Keyword(s):

Pregnancy Outcomes ◽

Loss Rate ◽

Fetal Loss ◽

Adverse Pregnancy Outcomes ◽

Expert Group ◽

Second Trimester ◽

Single Institution ◽

Adverse Pregnancy ◽

In Pregnancy ◽

Singleton Pregnancies

AbstractObjectivesTo compare the rate of fetal loss in pregnancy after second trimester amniocentesis between procedures performed by experts and non-experts and to assess other pregnancy complications as secondary outcomes.MethodsA retrospective cohort study was performed on singleton pregnancies that underwent mid-trimester amniocenteses in a single institution. The fetal loss rates of procedures performed by experts and non-experts were collected and analyzed. Other adverse pregnancy outcomes were also examined.ResultsIn total, 14,450 amniocenteses were performed during the study period. These included 11,357 (78.6%) procedures in the group expert operators and 3,093 (21.4%) procedures in the group non-expert operators. In the non-expert group, the fetal loss rate was slightly increased but not significantly (p=0.24).In addition, the higher number of spontaneous abortions was associated with blood-stained amniotic fluid sample (p<0.001; RR=9.28). Multiple needle insertions also increased in the non-expert group significantly. However, no difference in pregnancy outcomes was found between in single and multiple needle insertions.ConclusionsThe amniocentesis procedures performed by the non-experts was not increase the fetal loss rate. However, the other adverse pregnancy outcomes, including preterm birth, low birth weight and fetal growth restriction were significantly increased in the non-expert group.

Download Full-text