Maternal serum analyte levels after first-trimester multifetal pregnancy reduction


      OBJECTIVE: Our purpose was to assess the effect of multifetal pregnancy reduction on maternal serum levels of analytes used for screening low-risk women for fetal chromosome abnormalities and neural tube defects. STUDY DESIGN: Peripheral blood samples were obtained between 15.0 and 20.9 weeks' gestation from 10 consecutive women who had undergone first-trimester multifetal pregnancy reduction. The samples were assayed for levels of α-fetoprotein, human chorionic gonadotropin, and unconjugated estriol. Analyte concentrations were interpreted within our maternal serum screening program. RESULTS: Levels of α-fetoprotein were significantly elevated in all samples. In each pregnancy levels of human chorionic gonadotropin and unconjugated estriol were consistent with the number of continuing gestations. CONCLUSIONS: First-trimester multifetal reduction does not alter second-trimester levels of human chorionic gonadotropin and unconjugated estriol. Further study is needed to determine whether these analytes could be used to screen pregnancies for fetal chromosome abnormalities after first-trimester multifetal reduction. (AM J OBSTET GYNECOL 1996;174:1072-4.)


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Obstetrics & Gynecology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Wapner RJ
        • Davis GH
        • Johnson A
        • et al.
        Selective reduction of multifetal pregnancies.
        Lancet. 1990; 335: 90-93
        • Yovel I
        • Yaron Y
        • Amit A
        • et al.
        Embryo reduction in multifetal pregnancies using saline injection: comparison between the transvaginal and the transabdominal approach.
        Hum Reprod. 1992; 7: 1173-1175
        • Berkowitz RL
        • Lynch L
        • Lapinski R
        • Bergh P.
        First-trimester transabdominal multifetal pregnancy reduction: a report of two hundred completed cases.
        AM J OBSTET GYNECOL. 1993; 169: 17-21
        • Tabsh KM.
        A report of 131 cases of multifetal pregnancy reduction.
        Obstet Gynecol. 1993; 82: 57-60
        • Evans MI
        • Dommergues M
        • Wapner RJ
        • et al.
        Efficacy of transabdominal multifetal pregnancy reduction: collaborative experience among the world's largest centers.
        Obstet Gynecol. 1993; 82: 61-66
        • Timor-Tritsch IE
        • Peisner DB
        • Monteagudo A
        • Lerner JP
        • Sharma S.
        Multifetal pregnancy reduction by transvaginal puncture: evaluation of the technique used in 134 cases.
        AM J OBSTET GYNECOL. 1993; 168: 799-804
        • Melgar CA
        • Rosenfeld DL
        • Rawlinson K
        • Greenberg M.
        Perinatal outcome after multifetal reduction to twins compared with nonreduced multiple gestations.
        Obstet Gynecol. 1991; 78: 763-767
        • Grau P
        • Robinson L
        • Tabsh K
        • Crandall BF.
        Elevated maternal serum alpha-fetoprotein and amniotic fluid alpha-fetoprotein after multifetal pregnancy reduction.
        Obstet Gynecol. 1990; 76: 1042-1045
        • Lynch L
        • Berkowitz RL
        Maternal serum α-fetoprotein and coagulation profiles after multifetal pregnancy reduction.
        AM J OBSTET GYNECOL. 1993; 169: 987-990
        • Phillips OP
        • Elias S
        • Shulman LP
        • Andersen RN
        • Morgan CD
        • Simpson JL.
        Maternal serum screening for fetal Down syndrome in women less than 35 years of age using alpha-fetoprotein, hCG and unconjugated estriol: a prospective 2-year study.
        Obstet Gynecol. 1992; 80: 353-358
        • Palomaki GE
        • Knight GJ
        • McCarthy J
        • Haddow JE
        • Eckfeldt JH.
        Maternal serum screening for fetal Down syndrome in the United States: a 1992 survey.
        AM J OBSTET GYNECOL. 1993; 169: 1558-1562
        • Palomaki GE
        • Knight GJ
        • Haddow JE
        • Canick JA
        • Saller Jr, DN
        • Panizza DS.
        Prospective intervention trial of a screening protocol to identify fetal trisomy 18 using maternal serum alpha-fetoprotein, unconjugated estriol and human chorionic gonadotropin.
        Prenat Diagn. 1992; 12: 925-930
      1. American College of Obstetricians and Gynecologists Committee on Obstetric Practice. Down syndrome screening. : American College of Obstetricians and Gynecologists, Washington (DC)1994 (Committee Opinion No. 141)
        • Johnson MR
        • Abbas A
        • Nicolaides KH.
        Maternal plasma levels of human chorionic gonadotropin, oestradiol and progesterone in multifetal pregnancies before and after fetal reduction.
        J Endocrinol. 1994; 143: 309-312
        • Cuckle HS
        • Wald NJ.
        HCG, estriol and other maternal blood markers of fetal aneuploidy.
        in: Maternal serum screening for fetal genetic disorders. : Churchill-Livingstone, New York1992: 88-90