2ND-TRIMESTER MATERNAL SERUM ALPHA-FETOPROTEIN, HUMAN CHORIONIC-GONADOTROPIN, AND UNCONJUGATED ESTRIOL AFTER EARLY TRANSVAGINAL MULTIFETAL PREGNANCY REDUCTION
A. Groutz et al., 2ND-TRIMESTER MATERNAL SERUM ALPHA-FETOPROTEIN, HUMAN CHORIONIC-GONADOTROPIN, AND UNCONJUGATED ESTRIOL AFTER EARLY TRANSVAGINAL MULTIFETAL PREGNANCY REDUCTION, Prenatal diagnosis, 16(8), 1996, pp. 723-727
Maternal serum alpha-fetoprotein (MSAFP), human chorionic gonadotropin
(hCG), and unconjugated oestriol (UE(3)) are used as second-trimester
screening markers for the detection of various fetal abnormalities. P
revious studies have suggested that second-trimester MSAFP is consiste
ntly elevated after late first-trimester transabdominal multifetal pre
gnancy reduction (MFPR), The present study was undertaken to evaluate
the levels of all three markers after early transvaginal MFPR, Materna
l serum was examined for MSAFP; hCG, and UE(3) at 16-18 weeks' gestati
on in 28 patients who underwent transvaginal MFPR at approximately 10
weeks' gestation. The mean interval between the reduction procedure an
d the screening test was 7.2 +/- 0.9 weeks. The mean MSAFP value in 24
patients carrying viable twins was 2.49 +/- 0.99 multiples of the med
ian (MOM), Two patients had elevated MSAFP values: one in association
with omphalocoele and the other in relation to an adverse pregnancy ou
tcome. All but two patients had normal hCG values (mean 1.98 +/- 1.26
MOM), Two cases with elevated hCG were associated with an adverse preg
nancy outcome. Unconjugated oestriol values were within the normal ran
ge in all patients (mean 1.69 +/- 0.61 MOM). These results suggest tha
t early transvaginal MFPR, at approximately 10 weeks' gestation, does
not appear to influence second-trimester MSAFP, hCG, and UE(3) levels.
The values of these markers may therefore be interpreted by using the
same criteria as those for the general obstetric population.