FOLLOW-UP OF PREGNANT WOMEN THROUGH NONINVASIVE SCREENING PROGRAMS
- Authors: BAKHAREV V.A1, KARETNIKOVA N.A1, STYGAR A.M1, EKIMOVA E.V1, KOLODKO V.G1
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Affiliations:
- Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health and Social Development of Russia
- Issue: No 7-2 (2011)
- Pages: 20-23
- Section: Articles
- URL: https://journals.eco-vector.com/0300-9092/article/view/246611
- ID: 246611
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Abstract
Objective. To study whether it is expedient to make noninvasive monitoring, by determining the time course of changes in serum markers in pregnant women. Subjects and methods. Three hundred and nine women in the first and second trimesters of pregnancy were examined, by using ultrasonography, by measuring the level of serum markers, such as free β-subunit of human chorionic gonadotropin (β-hCG) and pregnancy-associated plasma protein A in the first trimester, human chorionic gonadotropin, alpha-fetoprotein, estriol (E3) in the second trimester, by making a computer analysis using Life Cycle programs in the first trimester and PRISCA in the second one, and by applying invasive prenatal diagnostic methods. The data were statistically processed employing the McNemar, chi-square, and Fletcher tests. Results. Risk-group pregnant women diagnosed as having a baby with Down syndrome in their first trimester in 100% of cases were identified. The test specificity was 66.3%; the rate of false-positive results was 32.7%. In the second trimester, the changes in the levels of serum markers were unnatural and, in most cases, associated with obstetric pathology or age. In this trimester, specificity and false-positive rates were 24.0 and 72.8%, respectively. The high false-positive rates were mainly due to the elevated levels of β-hCG and E3. No relationship could be found between medical history data, the course of pregnancy, the levels of serum markers, and the risk for a baby to be born with a chromosomal abnormality; a karyotype abnormality was absent. Conclusion. If there is a risk for a baby to be born with a chromosomal abnormality, embryonic karyotyping should be carried out in the first trimester of pregnancy, without waiting for the results of the second trimester. Second-trimester examination should be done if it is absent in early periods.
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About the authors
V. A BAKHAREV
Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health and Social Development of Russia
Email: info@ncagip.ru
N. A KARETNIKOVA
Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health and Social Development of Russia
A. M STYGAR
Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health and Social Development of Russia
E. V EKIMOVA
Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health and Social Development of Russia
V. G KOLODKO
Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health and Social Development of Russia
References
- Барашнев Ю.И., Бахарев В.А. Эмбриофетопатии. - М.: Триада-Х, 2. 2010. - С. 343-396.
- Бахарев В.А., Каретникова Н.А., Стыгар А.М. и др. Хорионический гонадотропин и его свободная β-субъединица при беременности // Пробл. репрод. -2007. - № 1. - С. 96-98.
- Кулаков В.И., Серов В.Н., Демидов В.Н. и др. Алгоритм пренатального мониторинга // Акуш. и гин. - 2000. - № 5. - С. 56-59.
- Флетчер Р., Флетчер С., Вагнер Э. Клиническая эпидемиология. Основы доказательной медицины. - М.: Медиа сфера, 1998.
- Avigdou K., Papageorghiou A., Bindra R. et al. Prospective first -trimester screening for trisomy 21 in 30,564 pregnancies // Am J. Obstet. Gynecol. -2005. - Vol. 192. - P. 1761-1767.
- Been P. A., Donnenfeld A.F. Sequential down syndrome screening: The impotance of first and second trimester test correlations when calculating risk // Cenet. Counseling. - 2005. - Vol. 10. -P. 6390-6397.
- Liao A.W., Heath N., Kamelas K. First-trimester screening for trisomy 21 singleton pregnancies achived by assisted reproduction // Hum. Reprod. - 2001. - Vol. 16.- P. 1501-1504.
- Malone F. D., Canick J. A., Ball R.H. et al. First- trimester screening or second - trimester screening, or both, for Down's syndrome // N. Engl. J. Med. - 2005. -Vol. 353. - P. 2001-2011.
- Miller F., Dreux S., Lemeu R. A. Medically assisted reproduction and second trimester maternal serum marker screening for Down syndrome // Prenat. Diagn. - 2003. - Vol. 23. -P. 1073-1076.
- Nimlaides K.H. Nuchal translucency and other first - trimester sonographic markers of chromosomal abnormalities // Am J. Obstet. Gynecol. -2004. - Vol. 191. - P. 45-67.
- Platt L.D., Greene N., Johnson A. et al. Sequential pathways of testing after first- trimester screening for trisomy 21 // Obstet. and Gynecol. - 2004. - Vol. 104. - P. 661-665.
- Wald N. J., Watt H.C., Hackshaw A.K. Integrated screening for Down's syndrome on the basis of tests performed during first and second trimesters // N. Engl. J. Med. - 1999. - Vol. 341. -P. 461-467.
- Wald N. J., Rodeck C., Hackshaw A.K. et al. First and second trimester antenatal screening for Down's syndrome: the results of the Serum, Urine and Ultrasound Screening Study (SURUSS)//J. Med. Screen. - 2003. - Vol. 10. -P. 56 -104.
- Wapner R., Thom E., Simpson J.L. First - trimester screening for trisomies 21 and 18 // N. Engl. J. Med. - 2003. - Vol. 349. -P. 1405-1413.
- Wright D., Bradbury I., Benn P. et al. Contingent screening for Down's syndrome is an efficient alternative to non-disclosure sequential screening // Prenat. Diagn. - 2004. - Vol. 24. -P. 762-766.
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