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Quadruple test parameters in art pregnancies.

ABSTRACT: AIM:Quadruple test is used for Down's syndrome screening in the second trimester of pregnancy. The aim of this study was to investigate differences in quadruple test parameters between pregnancies achieved by assisted reproductive treatments (ART) and spontaneous conception. MATERIALS AND METHODS:We retrospectively compared levels of alfa-fetoprotein (AFP), unconjugated Estriol (uE3), inhibin-A and hCG and also screen positive test results. RESULTS:Levels of all quadruple test parameters were statistically significantly increased in ART pregnancies when compared to spontaneous pregnancies, AFP was 1.4±0.74 and 1.16±0.53, (p=0.001), uE3 was 1.10±0.37 and 1.00±0.28, (p=0.004), hCG was 1.56±1.04 and 1.26±0.76, (p=0.001), inhibin A was 1.38±0.76 and 1.08±0.57, (p=0.001), screen positive tests were nearly doubled (4.8% and 8.4%). CONCLUSIONS:Increased screen positive test results and quadruple test parameters in ART pregnancies may lead to unnecessary amniocentesis.

SUBMITTER: Guducu N

PROVIDER: S-EPMC4161588 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

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Quadruple test parameters in art pregnancies.

Güdücü Nilgün N Görmüş Uzay U Güner Ebru İlhan Eİ Güzel Omer O Kavak Zehra Neşe ZN

International journal of clinical and experimental medicine 20140815 8

<h4>Aim</h4>Quadruple test is used for Down's syndrome screening in the second trimester of pregnancy. The aim of this study was to investigate differences in quadruple test parameters between pregnancies achieved by assisted reproductive treatments (ART) and spontaneous conception.<h4>Materials and methods</h4>We retrospectively compared levels of alfa-fetoprotein (AFP), unconjugated Estriol (uE3), inhibin-A and hCG and also screen positive test results.<h4>Results</h4>Levels of all quadruple t ...[more]

PMID: 25232428

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Project description:Background At present, the prevalence of pregestational diabetes is 2.2% with an overall prevalence of hyperglycaemia in pregnancy of about 16.2%. Fetuses of diabetic mothers are at risk of functional cardiac abnormalities without structural cardiac anomalies especially in the third trimester. The main aim of this study was to assess the association of diabetes with different fetal echocardiographic parameters. Methods A case control study comprising a total of 120 pregnant women (60 cases and 60 controls). The cases group included fetuses of mothers known to have pre-gestational type 2 diabetes (DM group) while the control group included fetuses of euglycaemic healthy pregnant women. They were examined twice at 23–24 weeks' gestation (visit 1) and followed up at 27–28 weeks’ gestation (visit 2). The Modified Myocardial Performance Index (Mod MPI) was obtained in all fetuses. Also, M-mode echocardiography was used to measure the interventricular septum thickness at diastole in a transverse four chamber view. Results There was a significant increase in Iso-volumetric contraction time (ICT) (45.4 ms ± 8.9), Iso-volumetric relaxation time (IRT) (54.7 ms ± 11.22), Interventricular septal thickness (IVST) (4.08 mm ± 0.8), aortic acceleration time (AAT) (54.16 ms ± 12.77) and MPI (0.64 ± 0.09) in the diabetic group compared to the normal control group ICT (38.5 ms ± 9.59), IRT (46.13 ms ± 10.29), IVST (3.17 mm ± 0.6), AAT (49.73 ms ± 10.68) and MPI (0.5 ± 0.1) (all P values were < 0.001). When comparing parameters assessed at both visits among diabetic patients, there was a significant increase in IVST in the second visit (4.74 ± 0.78 mm) compared to the first visit (4.08 ± 0.8 mm) (P value < 0.05). The incidence of hypertrophic cardiomyopathy (HCM) was significantly higher in diabetic patients than in the control group. This is was observed in both first and second visit (33.4% and 56.7%) (P value < 0.001). Conclusions Fetuses of diabetic pregnant females show a significant increase in MPI, decrease in E\A ratio and HCM. These alterations in cardiac functions and structure were found to be continuous throughout the period of time between the two visits. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04969-5.

Project description:ObjectiveTo evaluate the efficacy of the quadruple test for potential use as a Thai national policy for Down syndrome (DS) screening and establish an accurate equation for risk estimation of Down syndrome based on gestational age, weight and the ethnic-specific reference range of our population.MethodsA prospective study was conducted on singleton pregnancies at 14 to 21 weeks of gestation to evaluate the efficacy of quadruple DS screening using the automatically calculated Western European descent factor (WF) in our population and the impact of screening using a specific Thai ethnic factor as well as to establish an equation for the risk estimation of DS based on gestational age, weight and a local Thai ethnic factor to correct for the impact of ethnic factor on the screening efficacy.ResultsOf a total of 5,515 women, 12 cases of DS and 8 cases of other aneuploidies were found. The detection rate, false positive rate and specificity were 75.0%, 9.1% and 90.9%, respectively, by automatic calculation with the widely used WF; the screening efficacy was lower when used in Asian populations than in other studies. The best-fitted regression equation of serum quadruple screening of AFP, free β-hCG, uE3 and inhibin A was established by adjustment for gestational age (GA) in days, maternal weight and our Thai-specific ethnic reference range which was created for this study. Calculations with our Thai-specific ethnic model gave a better detection rate of 83.3%, a false positive rate of 9.6% and specificity of 90.4%.ConclusionThe serum quadruple test had a lower detection rate than expected when the risk estimation was based on the WF reference range. The serum quadruple test using WF had significantly different levels when corrected with our ethnic-specific factor. Using our local ethnic specific model could increase the detection rate of DS screening in Thailand with a minimal increase in false positive rates. Our findings indicate that DS screening should be adjusted with an appropriate individual ethnic factor when used for national screening.

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Quadruple test parameters in art pregnancies.

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Quadruple test parameters in art pregnancies.

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