Second-trimester diurnal variation of maternal serum alpha-fetoprotein, human chorionic gonadotropin, and unconjugated oestriol: Is it present and does it affect the prediction of a patient's risk for fetal down syndrome?

1994 ◽  
Vol 14 (10) ◽  
pp. 947-951 ◽  
Author(s):  
Nancy C. Rose ◽  
Jacob A. Canick ◽  
George J. Knight ◽  
Andrea Pulkkinen ◽  
M. B. Tumber ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Diurnal Variation ◽  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Maternal Serum ◽  
Alpha Fetoprotein ◽  
Second Trimester ◽  
Serum Alpha Fetoprotein

scholarly journals Invasive Trophoblast Antigen (Hyperglycosylated Human Chorionic Gonadotropin) in Second-Trimester Maternal Urine as a Marker for Down Syndrome: Preliminary Results of an Observational Study on Fresh Samples

2004 ◽  
Vol 50 (1) ◽  
pp. 182-189 ◽  
Author(s):  
Glenn E Palomaki ◽  
George J Knight ◽  
Marie M Roberson ◽  
George C Cunningham ◽  
Jo Ellen Lee ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Observational Study ◽  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
False Positive Rate ◽  
Serum Markers ◽  
Maternal Serum ◽  
Second Trimester ◽  
Preliminary Results ◽  
Hyperglycosylated Human Chorionic Gonadotropin

Abstract Background: Down syndrome screening is commonly performed in the US using maternal age and three or four second-trimester maternal serum markers that can identify up to 75% of affected pregnancies by offering diagnostic studies to 5% of women. Invasive trophoblast antigen [ITA; hyperglycosylated human chorionic gonadotropin (hCG)] is a promising marker that can be measured in urine or serum in the first or second trimester. We report preliminary results for urinary ITA in an ongoing observational study. Methods: Women undergoing second-trimester amniocentesis for reasons not associated with biochemical testing provided consent and a urine (and possibly serum) sample that was tested within a few days. Demographic and pregnancy-related information was collected, along with karyotype. Screening performance was modeled for ITA alone and in combination with serum markers Results: Twelve recruitment centers collected urine from 2055 women with singleton pregnancies between 15 and 20 weeks of gestation (2023 unaffected, 28 Down syndrome, and 4 pregnancies with other chromosome abnormalities). After correction for gestational age, urine concentration, and maternal race and weight, the ITA measurements were higher in women with a Down syndrome pregnancy (median ITA, 4.33 multiples of the median). At a 75% detection rate, the false-positive rate could be reduced by substituting ITA for hCG measurements (from 5.6% to 2.6% for the triple test) or by adding ITA measurements to existing combinations (from 3.3% to 2.0% for the quadruple test). Conclusions: Our data provide preliminary confirmation of the potential usefulness of urinary ITA measurements in detecting Down syndrome in a setting that simulates routine usage.

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