The Determination of Medians of Biochemical Maternal Serum Markers in Healthy Women Giving Birth to Normal Babies. | [Pakistan Armed Forces Medical Journal • 2018]

Author(s):

1. Asif Nawaz: Armed Forces Institute of Pathology (AFIP), National University of Medical Sciences (NUMS), Rawalpindi, Pakistan

2. Tariq Bin Sharif: Armed Forces Institute of Pathology (AFIP), National University of Medical Sciences (NUMS), Rawalpindi, Pakistan

3. Hamza Akhtar: Dow University of Health Sciences (DUHS), Karachi, Pakistan

4. Aamir Ijaz: Armed Forces Institute of Pathology (AFIP), National University of Medical Sciences (NUMS), Rawalpindi, Pakistan

5. Noreen: Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan

6. Quratulain: Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan

Abstract:

Objective: To determine median values of biochemical maternal serum markers during second trimester maternal screening to rule out chromosomal anomaly, Down syndrome. Study Design: Cross sectional study. Place and Duration of Study: Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology (AFIP), from Nov 2016 to May 2017. Patients and Methods: Non-probability consecutive sampling technique was used. All healthy pregnant women with single pregnancy were included. As non-parametric statistics was used, the sample size was collected to be 155. Blood sample for serum human chorionic gonadotropin (HCG) was analyzed on random access immulite 2000, alpha-fetoprotein (AFP) was analyzed on ADVIA Centaur, unconjugated estriol (uE3) and Inhibin A measured by Enzyme-Linked Immunosorbent Assay (ELISA) method by PR 4100 Micro plate Reader. Results: Total 155 women were enrolled in this study. Mean maternal age was 33.46 ± 2.35 years and mean maternal body weight was 54.98 ± 2.88 kg. Median value of quadruple markers, calculated from 15-18th week of gestation, was used for calculation of multiple of median (MoM) for screening of trisomy21 in this gestational age. Median values at 15 week of gestation: hCG 36650 mIU/ml, AFP 23.3 IU/ml, uE3 3.5 nmol/l, Inh A 198 ng/l, at 16 week of gestation: hCG 29050 mIU/ml, AFP 35.4 IU/ml, uE3 4.1 nmol/l, Inhibin-A 179 ng/l; at 17 week of gestation: hCG 28450 mIU/ml, AFP 36.0 IU/ml, uE3 6.7 nmol/l, Inhibin-A 175 ng/l and at 18 week of gestation: HCG 25200 mIU/ml, AFP 38.2 IU/ml, uE3 8.2 nmol/l, Inhibin-A 190 ng/l. Conclusion: In this study we were able to get median values of quadruple markers for regional population, which will be used in future to calculate MoM for the screening purpose of Down syndrome. It will help to rule out Down syndrome by non-invasive test and at early stage of pregnancy.

Page(s): 185-190

DOI: DOI not available

Published: Journal: Pakistan Armed Forces Medical Journal, Volume: 68, Issue: 2, Year: 2018

Keywords:

Keywords are not available for this article.

References:

[1] CuckleHS, 2010.Benn PA. Multi Marker Maternal Serum Screening for Chromosomal Abnormalities,Genetic Disorders and the Fetus, Sixth Edition 771 -818

[2] BaerRJ,FlesselMC,Jelliffe-PawlowskiLL,GoldmanS,HudginsL,HullAD, 2015.Detection rates for aneuploidy by first-trimester and sequential screening,Obstet Gynecol 126 753 -9

[3] ShawSS,LinSY,LinCH,SuYN,ChengPJ,LeeCN,ChenCP, 2010.Second-trimester maternal serum quadruple test for Down syndrome screening: A Taiwanese population-based study,Taiwan J Obstet Gynecol 49 30 -4

[4] GhaffariSR,TahmasebpourAR,JamalA,HantoushzadehS,EslamianL,MarsoosiV, 2012.First trimester screening for chromosomal abnormalities by integrated application of nuchal translucency, nasal bone, tricuspid regurgitation and ductus venosus flow combined with maternal serum free β hCG and PAPP A: A 5 year prospective study,Ultrasound obstet Gynecol 39 528 -34

[5] CohenJL,SmilenKE,BiancoAT,MoshierEL,FerraraLA,StoneJL, 2014.Predictive value of combined serum biomarkers for adverse pregnancy outcomes,Eur J Obstet Gynecol Reprod Biol 181 89 -94

[6] CurrierR,WuN,Van MeterK,GoldmanS,LoreyF,FlesselM. Integrated, 2012.and first trimester prenatal screening in California: program implementation and patient choice for follow up services,Prenat Diagn 32 1077 -83

[7] KrzyżanowskiA,GęcaT,KwiatekM,KwaśniewskaA, 2015.Chromosomal abnormalities in a decade of prenatal testing at the Department of Obstetrics and,Polish Journal of Public Health 125 29 -31

[8] MoorthieS,BlencoweH,DarlisonMW,GibbonsS,LawnJE,MastroiacovoP, 2017.Chromosomal disorders: Estimating baseline birth prevalence and pregnancy outcomes worldwide,J Community Genet -

[9] ChenBY,HwangBF,GuoYL, 2009.Epidemiology of congenital anomalies in a population-based birth registry in Taiwan, 2002,J Formos Med Assoc 108 460 -8

[10] LiY,ZhangX,SunY,HongD,WangY,XuZ, 2017.Combined detection of α-fetoprotein and free β human chorionic gonadotropin in screening for trisomy 21 and management of cases in the moderate risk value range,Mol Clin Oncol 7 623 -8

[11] VrankenG,ReynoldsT,NuetenJV, 2006.Medians for secondtrimester maternal serum markers: geographical differences and variations caused by median multiples-of-median equations,J Clin Pathol 59 639 -44

[12] YaoY,LiaoY,HanM,LiSL,LuoJ,ZhangB, 2016.Two kinds of common prenatal screening tests for Down's syndrome: A systematic review and meta-analysis,Sci Rep 6 18866 -

[13] BallS,WrightD,SodreD,LachmannR,NicolaidesKH, 2012.Temporal effect of Afro-Caribbean race on serum pregnancy-associated plasma protein-a at 9-13 weeks' gestation in screening for aneuploidies,Fetal Diagn Ther 31 162 -9

[14] SpencerK,HeathV,El SheikhahA,OngCY,NicolaidesKH, 2005.Ethnicity and the need for correction of biochemical and ultrasound markers of chromosomal anomalies in the first trimester: A study of Oriental, Asian and Afro Caribbean populations,Prenat Diagn 25 365 -9

[15] KaurG,SrivastavJ,SharmaS,HuriaA,GoelP,ChavanBS, 2013.Maternal serum median levels of alpha-foetoprotein, human chorionic gonadotropin & unconjugated estriol in second trimester in pregnant women from north-west India,Indian J Med Res 138 83 -88

[16] Abou-YoussefHS,KamalMM,MehaneyDA, 2014.Triple test screening for Down syndrome: An Egyptian-tailored study,PloS one 9 e110370 -

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