The contribution of maternal serum markers in the early prenatal diagnosisof molar pregnancies

The aim of this study was to evaluate the usefulness of maternal serum mark ers in the early prenatal diagnosis of molar pregnancies. The ultrasound fe atures, cytogenetic and histopathological findings of 10 cases of molar pre gnancy diagnosed at 11-13 weeks of gestation were compared retrospectively with the maternal serum concentrations of human chorionic gonadotrophin (HC G), alpha fetoprotein (AFP), pregnancy-associated plasma protein A (PAPP-A) and pregnancy-specific beta 1-glycoprotein (SP1). Free beta-HCG and intact HCG concentrations were very high [greater than or equal to 2.5 multiples of the median (MoM)] in all cases. AFP concentrations were extremely low in all cases of singleton complete moles (less than or equal to 0.5 MoM) and were high in one case of twin complete mole, in one case of triploid partia l mole and two cases of euploid partial mole (greater than or equal to 2.5 MoM), Serum PAPP-A and SP1 were high in complete moles. The combined use of ultrasound features, maternal serum proteins and fetal cytogenetic finding s should enable the early differential diagnosis in utero and perinatal man agement of those molar pregnancies presenting with an anatomically normal f etus.