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THE ASSOCIATION OF EARLY‐ONSET FETAL GROWTH RESTRICTION, ELEVATED MATERNAL SERUM ALPHA‐FETOPROTEIN, AND THE DEVELOPMENT OF SEVERE PRE‐ECLAMPSIA
Author(s) -
SHIPP THOMAS D.,
WILKINSHAUG LOUISE
Publication year - 1997
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/(sici)1097-0223(199704)17:4<305::aid-pd60>3.0.co;2-f
Subject(s) - medicine , hellp syndrome , obstetrics , fetus , intrauterine growth restriction , eclampsia , gestational age , gestation , pregnancy , preeclampsia , small for gestational age , gynecology , genetics , biology
From Antenatal Diagnostic Center referrals over 22 months, consultations for early‐onset fetal growth restriction versus skeletal dysplasia were retrospectively identified. Those with elevated maternal serum alpha‐fetoprotein (MSAFP) levels are the focus of this report. All had an early ultrasound confirming menstrual dates and subsequent sonography at <28 weeks with at least two fetal biometric measures delayed by ≥2 standard deviations from mean values. Of the five patients identified, the mean gestational age at the time of diagnosis of fetal growth restriction was 23·3±2·9 weeks. All had normal karyotypes and normal amniotic fluid AFP. None of the patients had evidence of hypertension or pre‐eclampsia at diagnosis of fetal growth restriction. All five gravidas subsequently developed severe pre‐eclampsia from 5·5 to 12·5 weeks after documentation of fetal growth delay. Three developed HELLP syndrome. Pregnancies were continued a mean duration of 10·2 weeks, with all five delivering at preterm gestations (mean=33·5±1·7 weeks) for maternal indications of severe pre‐eclampsia. Unexplained early‐onset fetal growth restriction in conjunction with unexplained elevations of MSAFP together consistently heralded the subsequent development of severe pre‐eclampsia. © 1997 by John Wiley & Sons, Ltd.