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EP07.02: First trimester ultrasound findings for detecting rare chromosomal aberrations
Author(s) -
Nakamura Y.,
Fujita S.,
Tajima A.,
Song M.,
MatsumotoRunser J.,
Kurata Y.,
Arakawa H.,
Tamura C.
Publication year - 2018
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.19879
Subject(s) - medicine , cystic hygroma , trisomy , amniocentesis , omphalocele , ultrasound , monosomy , first trimester , obstetrics , aneuploidy , gynecology , prenatal diagnosis , pregnancy , fetus , radiology , chromosome , karyotype , genetics , biology , gene
Objectives: Maternal serum markers in 1st and 2nd trimesters are widely used for screening test of aneuploidy. Although demised fetus may affect the serum markers, vanishing twin (VT) is not considered as an adjustment factor for risk assessment. The purpose of this study was to evaluate the effect of VT on 1st and 2nd trimester maternal serum markers and nuchal translucency (NT). Methods: This is a secondary analysis of a multicenter prospective cohort study, which was designed to evaluate the cost-effectiveness of various prenatal test strategies for Down’s syndrome. Pregnant women were enrolled in 12 institutions. Among 5,188 cases, 3,616 cases adopted serum markers, including 56 cases with VT(1.55%) and 3,560 cases with normal singleton controls. All VT was found during 1st trimester (range; 7.29-9.13). We used pregnancy associated plasma protein A (PAPP-A) as 1st trimester serum marker and α-fetoprotein (aFP), total β-human chorionic gonadotrophin (beta-hCG), unconjugated estriol (uE3), and inhibin A as 2nd trimester serum marker and NT in the 1st trimester. All markers were compared between two groups with multiple of the median (MoM). Results: Compared with controls, cases with VT had higher MoM of aFP[median MoM(range) 1.260(0.940-1.515) for VT; medican MoM(range) 0.980(0.809-1.220), p=.001] and inhibin A[(median MoM(range) 1.120(0.868-1.370) for VT; medican MoM(range) 1.010(0.766-1.291), p=.045). The other markers did not show significant difference between two groups (table). These findings were remained significant after adjustment for confounding variables including maternal age, prepregnancy BMI, and mode of conception. Conclusions: In conclusion, VT can be considered as an adjustment factor for risk assessment in the 1st and 2nd trimester serum screening test.