Prenatal diagnosis in multiple pregnancy

Thirty-one women with multiple pregnancy (22 women in the first trimester and 9 in the second trimester) and 22 randomly selected women with singleton pregnancy (a comparison for the first trimester) were examined, by using ultrasound study, biochemical screening, computer-assisted analysis, chorionic villus biopsy, amnio- or cardocentesis to determine the embryonic/fetal karyotype.
In the first trimester, 14 of the 22 women were found to be at high risk for birth of a baby with chromosomal abnormalities with increasing female age and with a larger embryonic nuchal region. The values of serum markers did not affect the risk degree. The level of the beta-subunit of human chorionic gonadotropin was similar in multiple and singleton pregnancy and that of pregnancy-associated plasma protein A significantly increased in multiple pregnancy. Chromosomal abnormality (Down and Edwards syndromes) was diagnosed in 2 embryos with a cervical fold. Their reduction was made. In the second trimester, the basic criteria for evaluating the fetal status were ultrasound findings when screening programs were used. In 64 embryos/fetuses (in 31 women), pathology was diagnosed in 7 (10.9%), including the karyotype in 3.1% (2/64) and the phenotype in 16.1% (5/64).
The results of the study support the expediency of using the whole package of prenatal diagnostic techniques, preferably as early in pregnancy as possible. The results of ultrasound study and karyotyping are of the greatest informative value for this group of women.

multiple pregnancy, prenatal diagnosis