ELEVATED MIDTRIMESTER HCG AND MATERNAL LUPUS ANTICOAGULANT

An association is described between women with lupus anticoagulant and abnormal prenatal serum screening results. Three cases of positive se cond-trimester serum screening for Down syndrome, with karyotypically normal fetuses, in women demonstrated to have lupus anticoagulant are presented. Serum screening positivity was principally due to a disprop ortionately elevated maternal serum human chorionic gonadotrophin (hCG ) level, In each case, early, severe intrauterine growth restriction w as documented, with only one fetus surviving the neonatal period. As m aternal lupus anticoagulant may have a profoundly adverse effect on th e course of pregnancy, we suggest that an elevated hCG level on prenat al screening prompt consideration of maternal lupus anticoagulant test ing if ultrasonography demonstrates an otherwise normal singleton gest ation and the fetal karyotype is normal.