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Maternal serum α-fetoprotein, β-human chorionic gonadotropin, and unconjugated estriol levels in midtrimester trisomy 18 pregnancies

  • Author Footnotes
    a From the Baylor Prenatal Screening Program, Institute for Molecular Genetics, Baylor College of Medicine.
    Frank Greenberg
    Correspondence
    Reprint requests: Frank Greenberg, MD, Institute for Molecular Genetics, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030.
    Footnotes
    a From the Baylor Prenatal Screening Program, Institute for Molecular Genetics, Baylor College of Medicine.
    Affiliations
    Houston, Texas
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  • Author Footnotes
    a From the Baylor Prenatal Screening Program, Institute for Molecular Genetics, Baylor College of Medicine.
    Deborah Schmidt
    Footnotes
    a From the Baylor Prenatal Screening Program, Institute for Molecular Genetics, Baylor College of Medicine.
    Affiliations
    Houston, Texas
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  • Author Footnotes
    b the Department of Medicine, Baylor College of Medicine.
    Asha T. Darnule
    Footnotes
    b the Department of Medicine, Baylor College of Medicine.
    Affiliations
    Houston, Texas
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  • Author Footnotes
    a From the Baylor Prenatal Screening Program, Institute for Molecular Genetics, Baylor College of Medicine.
    Barbara R. Weyland
    Footnotes
    a From the Baylor Prenatal Screening Program, Institute for Molecular Genetics, Baylor College of Medicine.
    Affiliations
    Houston, Texas
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  • Author Footnotes
    a From the Baylor Prenatal Screening Program, Institute for Molecular Genetics, Baylor College of Medicine.
    Esmie Rose
    Footnotes
    a From the Baylor Prenatal Screening Program, Institute for Molecular Genetics, Baylor College of Medicine.
    Affiliations
    Houston, Texas
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  • Author Footnotes
    b the Department of Medicine, Baylor College of Medicine.
    Elliot Alpert
    Footnotes
    b the Department of Medicine, Baylor College of Medicine.
    Affiliations
    Houston, Texas
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  • Author Footnotes
    a From the Baylor Prenatal Screening Program, Institute for Molecular Genetics, Baylor College of Medicine.
    b the Department of Medicine, Baylor College of Medicine.
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      Objective: The purpose was to evaluate the levels of maternal serum human chorionic gonadotropin, α-fetoprotein, and unconjugated estriol in trisomy 18 pregnancies compared with normal singleton pregnancies.
      Study design: Sera from 14 trisomy 18 pregnancies (13 retrospectively and one prospectively ascertained) were analyzed for human chorionic gonadotropin, α-fetoprotein, and unconjugated estriol.
      Results: The α-fetoprotein levels in the 10 trisomy 18 pregnancies without open neural tube or ventral wall defect had a median of 0.65 multiple of the median, although two had α-fetoprotein levels above 2.5 multiples of the median. The human chorionic gonadotropin levels had a median of 0.32 multiple of the median and the unconjugated estriol levels had a median of 0.56 multiple of the median. Although most women with trisomy 18 pregnancies had serum human chorionic gonadotropin levels that were <1.0 multiple of the median, three had markedly elevated human chorionic gonadotropin levels (>5.0 multiples of the median).
      Conclusion: Our data are partially consistent with those previously published but suggest the possibility of a bimodal distribution of α-fetoprotein and human chorionic gonadotropin levels in trisomy 18-affected pregnancies, unrelated to a neural tube or abdominal wall defect. The efficiency of screening for trisomy 18 prospectively, using the three serum markers, requires further evaluation.

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      References

        • Merkatz IR
        • Nitowsky HM
        • Macri JN
        • Johnson WE
        An association between low maternal serum alpha-fetoprotein and fetal chromosomal abnormalities.
        Am J Obstet Gynecol. 1984; 148: 886-891
        • Canick JA
        • Knight GJ
        • Palomaki GE
        • Haddow JE
        • Cuckle HS
        • Wald NJ
        Low second trimester maternal serum unconjugated oestriol in pregnancies with Down's syndrome.
        Br J Obstet Gynaecol. 1988; 95: 330-333
        • Bogart MH
        • Pandian MR
        • Jones OW
        Abnormal maternal serum chorionic gonadotropin levels in pregnancies with fetal chromosome abnormalities.
        Prenat Diagn. 1987; 7: 623-630
        • Bogart MH
        • Golbus MS
        • Sorg ND
        • Jones OW
        Human chorionic gonadotropin levels in pregnancies with aneuploid fetuses.
        Prenat Diagn. 1989; 9: 379-384
        • Wald NJ
        • Cuckle HS
        • Densem JW
        • et al.
        Maternal serum screening for Down's syndrome in early pregnancy.
        Br Med J. 1988; 297: 883-887
        • Canick JA
        • Palomaki GE
        • Osathanondh R
        Prenatal screening for trisomy 18 in the second trimester.
        Prenat Diagn. 1990; 10: 546-548
        • Wald N
        • Cuckle H
        • Boreham J
        • Tezian E
        The effect of maternal weight on maternal serum alpha-fetoprotein levels.
        Br J Obstet Gynaecol. 1981; 88: 1094-1096
        • Lindenbaum RH
        • Ryynanen M
        • Holmes-Siedle M
        • Puhakainen E
        • Jonasson J
        • Keenan J
        Trisomy 18 and maternal serum and amniotic fluid alpha-fetoprotein.
        Prenat Diagn. 1987; 7: 511-519
        • Norgaard-Pedersen B
        • Larsen SO
        • Arends J
        • Svenstrup B
        • Tabor A
        Maternal serum markers in screening for Down syndrome.
        Clin Genet. 1990; 37: 35-43
        • Blitzer M
        • Carmi R
        • Blakemore K
        • Andrews NJ
        • Romem I
        • Schwartz S
        Low maternal serum human chorionic gonadotropin (MS-hCG) in second trimester trisomy 18 pregnancies.
        Am J Hum Genet. 1991; 49: 211