30. CHARACTERISTICS OF BIOMARKERS IN PREGNANCY SCREENING OF DOWN SYNDROME IN THE FIRST TRIMESTER OF PREGNANCY AT THE NATIONAL HOSPITAL OF OBSTETRICS AND GYNECOLOGY
Main Article Content
Abstract
Objective: Characteristics of some biomarkers related to prenatal screening in the first trimester of pregnancy at the National Hospital of Obstetrics and Gynecology.
Methods: Cross-sectional descriptive study based on 319 records of pregnant women meeting the criteria with gestational age from 11 weeks to 13 weeks 6 days.
Results: The distribution of MoM PAPP-A indices in the group of fetuses with Down syndrome concentrated mainly in the very lower value range while there was no difference in MoM fbHCG between these two groups. The cut-off threshold for the NT is 2.47mm. The cut-off values of MoM fβ-hCG and MoM PAPP-A were 2.485 and 0.657, respectively. NT and MoM fβ-hCG increase above the threshold value, and MoM PAPP-A decreases below the threshold value, increasing the possibility of pregnancy with Down syndrome.
Conclusions: Simultaneous biochemical testing and ultrasound are necessary for prenatal screening of Down syndrome in the first trimester of pregnancy.
Article Details
Keywords
Down Syndrome, Prenatal screening, PAPP-A; free β-hCG; nuchal translucency (NT).
References
ultrasound in first-trimester screening after
the introduction of NIPT as a service of public
health insurance - a consensus statement of the
Fetal Medicine Foundation (FMF) Germany;
Ultraschall Med - Eur J Ultrasound, 2023,
[2] Merz E, Thode C, Hackelöer BJ et al., The Fetal
Medicine Foundation (FMF) Germany after
20 Years - Quality Assurance of Ultrasound
Examinations during First Trimester Screening;
Ultraschall Med - Eur J Ultrasound, 2022, 43(2):
115-119.
[3] Varsha B, Flavia A, Alap C et al., First Trimester
Combined Aneuploidy Screening for Trisomy
21: A Three Years Retrospective Study; Journal
of Clinical & Diagnostic Research, 2022, 16(2):
BC05 - BC09.
[4] Fairbrother G, Burigo J, Sharon T et al., Prenatal
screening for fetal aneuploidies with cell-free
DNA in the general pregnancy population:
a cost-effectiveness analysis. J Matern-Fetal
Neonatal Med Off J Eur Assoc Perinat Med Fed
Asia Ocean Perinat Soc Int Soc Perinat Obstet,
2016, 29(7): 1160-1164.
[5] Rumi KM, Araujo JE, Silva BLC et al., Influence
of Second-Trimester Ultrasound Markers
for Down Syndrome in Pregnant Women of
Advanced Maternal Age; J Pregnancy, 2014,
2014:785730.
[6] Khoshnood B, De Vigan C, Vodovar V et al.,
A population-based evaluation of the impact
of antenatal screening for Down’s syndrome in
France: 1981-2000. BJOG Int J Obstet Gynaecol,
2004, 111(5): 485-490.
[7] Kagan KO, Wright D, Valencia C et al., Screening
for trisomies 21, 18 and 13 by maternal age,
fetal nuchal translucency, fetal heart rate, free
beta-hCG and pregnancy-associated plasma
protein-A. Hum Reprod Oxf Engl, 2008, 23(9):
1968-1975.
[8] Hoàng Thị Ngọc Lan, Nguyễn Đình Bắc, Phạm
Lê Sĩ Cường và cộng sự, Đánh giá giá trị của các
test sàng lọc trước sinh trong ba tháng đầu thai
kỳ để phát hiện thai hội chứng DOWN, Tạp chí
Phụ sản, 2017, 15(2): 12 – 17.
[9] Ziolkowska K, Dydowicz P, Sobkowski M
et al., The clinical usefulness of biochemical
(free β-hCg, PaPP-a) and ultrasound (nuchal
translucency) parameters in prenatal screening
of trisomy 21 in the first trimester of pregnancy.
Ginekol Pol, 2019, 90(3): 161-166.
[10] Wald N, Densem J, Stone R et al., The use of
free beta-hCG in antenatal screening for Down’s
syndrome. Br J Obstet Gynaecol, 1993, 100(6):
550-557.
[11] Younesi S, Eslamian L, Khalafi N et al., Extreme
βHCG levels in first trimester screening are risk
factors for adverse maternal and fetal outcomes.
Sci Rep, 2023, 13(1): 1228.