Intrahepatic cholestasis of pregnancy has no effect on maternal serum second trimester alpha-fetoprotein and hCG

Objective. To investigate the association between intrahepatic cholestasis and Down's syndrome screening analytes (alpha-fetoprotein [AFP] and hCG) du ring the second trimester. Design. Measurements of maternal serum AFP and hCG concentrations were retr ospectively analyzed in relation to intrahepatic cholestasis in a cohort of 33 consecutive singleton pregnancies affected by cholestasis from January 1995 through December 1997 at the University Hospital of Kuopio, and then c ompared with those in healthy singleton control pregnancies (n=5680) from t he same clinic over the same period of time. Results. Geometric means of maternal serum AFP and hCG concentrations in pr egnancies affected by cholestasis were 1.12 and 0.98 multiples of the media n [MoM], respectively. Mean maternal age was significantly higher in the su bjects than in controls (30.6 years compared with 28.8 years). In relation to Down's syndrome risk assessment, the pattern of the two markers together with maternal age indicated high risk as often in the study subjects as in the controls. Conclusion. Median serum AFP and hCG concentrations in pregnancies complica ted by intrahepatic cholestasis were not significantly different from those in unaffected pregnancies. There is no need to take the hepatic disorder i nto account in maternal serum screening.