TY - JOUR

T1 - First trimester prenatal screening in multiple pregnancies. Part II

T2 - Serum proteins PAPP-A and β-hCG as markers of adverse pregnancy outcomes

AU - Tsibizova, Valentina I.

AU - Govorov, Igor E.

AU - Pervunina, Tatiana M.

AU - Komlichenko, Eduard V.

AU - Kudryashova, Elena K.

AU - Blinov, Dmitry V.

AU - Makatsariya, Alexander D.

AU - Di Renzo, Gian C.

N1 - Publisher Copyright: © Telif Hakkı 2020 Türk Uyku Tıbbı Derneği / Türk Uyku Tıbbı Dergisi, Galenos Yayınevi tarafından basılmıştır.

PY - 2020

Y1 - 2020

N2 - Aim: to evaluate the ability of serum biochemical markers in pregnant woman - PAPP-A (pregnancy-associated plasma protein-A) and β-hCG (the β-subunit of human chorionic gonadotropin) studied in the first trimester (11+0-13+6) during combined prenatal screening to predict adverse perinatal outcomes of multiple pregnancy that occurred spontaneously and as a result of in vitro fertilization (IVF). Materials and methods. The main group consisted from 65 women with pregnancy occurred as a result of IVF; comparison group included 56 women with spontaneous pregnancy. All pregnancies were multiple and their outcomes were known. Serum PAPP-A and β-hCG levels were measured in the first trimester. The results were expressed in absolute values and in MoM (multiples of median). Subgroups were compared with mono- and dichorionic pregnancies, complicated and uncomplicated pregnancies, distributed according to MoM index: within the reference values (0.5-2.0), below or above the reference values. Results. PAPP-A MoM values in the spontaneous pregnancy group were 1.12 [0.8; 1.57], in the IVF group - 1.35 [1.11; 1.72] (p = 0.01). In subgroup of low PAPP-A MoM antenatal fetal death occurred in 50 %, in subgroup of normal PAPP-A MoM - in 14.58 %, in subgroup of high PAPP-A MoM - in 5.88 % (p = 0.011). In addition, a positive correlation was found between serum PAPP-A level and time of fetal death (rs = 0.564; p = 0.036). Low PAPP-A MoM values were associated with 50 % fetal mortality, 75 % of them were attributable to pregnancy as a result of IVF. Conclusion. Identification of adverse outcomes in multiple pregnancies is still a difficult task, but evaluation of serum biochemical markers during the first trimester screening can help in early diagnosis of necessity and extent of timely prophylaxis.

AB - Aim: to evaluate the ability of serum biochemical markers in pregnant woman - PAPP-A (pregnancy-associated plasma protein-A) and β-hCG (the β-subunit of human chorionic gonadotropin) studied in the first trimester (11+0-13+6) during combined prenatal screening to predict adverse perinatal outcomes of multiple pregnancy that occurred spontaneously and as a result of in vitro fertilization (IVF). Materials and methods. The main group consisted from 65 women with pregnancy occurred as a result of IVF; comparison group included 56 women with spontaneous pregnancy. All pregnancies were multiple and their outcomes were known. Serum PAPP-A and β-hCG levels were measured in the first trimester. The results were expressed in absolute values and in MoM (multiples of median). Subgroups were compared with mono- and dichorionic pregnancies, complicated and uncomplicated pregnancies, distributed according to MoM index: within the reference values (0.5-2.0), below or above the reference values. Results. PAPP-A MoM values in the spontaneous pregnancy group were 1.12 [0.8; 1.57], in the IVF group - 1.35 [1.11; 1.72] (p = 0.01). In subgroup of low PAPP-A MoM antenatal fetal death occurred in 50 %, in subgroup of normal PAPP-A MoM - in 14.58 %, in subgroup of high PAPP-A MoM - in 5.88 % (p = 0.011). In addition, a positive correlation was found between serum PAPP-A level and time of fetal death (rs = 0.564; p = 0.036). Low PAPP-A MoM values were associated with 50 % fetal mortality, 75 % of them were attributable to pregnancy as a result of IVF. Conclusion. Identification of adverse outcomes in multiple pregnancies is still a difficult task, but evaluation of serum biochemical markers during the first trimester screening can help in early diagnosis of necessity and extent of timely prophylaxis.

KW - Biochemical screening

KW - First trimester screening

KW - Free β-hCG

KW - Human chorionic gonadotropin

KW - In vitro fertilization

KW - IVF

KW - Multiple pregnancy

KW - PAPP-A

KW - Pregnancy-associated plasma protein-A

KW - Twins

UR - http://www.scopus.com/inward/record.url?scp=85083696329&partnerID=8YFLogxK

U2 - 10.17749/2313-7347.2020.14.1.34-43

DO - 10.17749/2313-7347.2020.14.1.34-43

M3 - Article

AN - SCOPUS:85083696329

VL - 14

SP - 34

EP - 43

JO - Акушерство, гинекология и репродукция

JF - Акушерство, гинекология и репродукция

SN - 2313-7347

IS - 1

ER -