FOLLOW-UP OF PREGNANT WOMEN THROUGH NONINVASIVE SCREENING PROGRAMS


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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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作者简介

V. 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. KARETNIKOVA

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health and Social Development of Russia

A. STYGAR

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health and Social Development of Russia

E. EKIMOVA

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health and Social Development of Russia

V. KOLODKO

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health and Social Development of Russia

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