The significance of the second trimester sonographic soft markers in pregnancies after normal first trimester screening

2013 ◽  
Vol 33 (8) ◽  
pp. 804-806 ◽  
Author(s):  
Marja Kaijomaa ◽  
Veli-Matti Ulander ◽  
Markku Ryynanen ◽  
Vedran Stefanovic
Keyword(s):  
First Trimester ◽  
Second Trimester ◽  
First Trimester Screening ◽  
Trimester Screening

scholarly journals Fetal Down syndrome screening models for developing countries; Part I: Performance of Maternal Serum Screening

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Chanane Wanapirak ◽  
Wirawit Piyamongkol ◽  
Supatra Sirichotiyakul ◽  
Fuanglada Tongprasert ◽  
Kasemsri Srisupundit ◽  
...  
Keyword(s):  
Developing Countries ◽  
Down Syndrome ◽  
Reference Range ◽  
First Trimester ◽  
Maternal Serum ◽  
Second Trimester ◽  
First Trimester Screening ◽  
Maternal Serum Screening ◽  
Serum Screening ◽  
Trimester Screening

Abstract Background To identify the performance of fetal Down syndrome (DS) screening for developing countries. Methods A prospective study on MSS (maternal serum screening) with complete follow-ups (n = 41,924) was conducted in 32 network hospitals in the northern part of Thailand. Various models of MSS were tested for performance. Results MSS based on Caucasian reference range resulted in very high false positive rate (FPR; 13%) in our country, compared to the rate of 7.8% with our own (Thai) reference range, whereas the detection rate was comparable. As individual screening, C-S (contingent first trimester screening including PAPP-A, and free beta-hCG, classified as a) high risk [> 1:30], indicated for invasive diagnosis; b) intermediate risk [1:30–1500], indicated for STS; and c) low risk [< 1:1500], need no further tests.) was the most effective model (sensitivity 84.9%, FPR 7.7%) but nearly one-third needed the second trimester test (STS) because of intermediate results. Additionally, about one-third had their first visits in the second trimester and had no chance of FTS (first trimester screening). C-S plus STS had a sensitivity of 82.4% and FPR 8.1% whereas independent first and second trimester screening model (I-S) gave the sensitivity of 78.4% and FPR of 7.5% but was much more convenient and practical. Conclusion C-S plus STS was the most effective models while I-S model was also effective and may be better for developing countries because of its simplicity and feasibility.

scholarly journals The relationship between first and second trimester biochemical parameters used to screen down syndrome and intrahepatic cholestasis of pregnancy

2021 ◽  
Vol 8 (12) ◽  
pp. 692-697
Author(s):  
Cuma Taşın ◽  
Nezaket Kadıoğlu ◽  
Revan Sabri Çiftçi ◽  
Hatun Çolak ◽  
Hakan Aytan
Keyword(s):  
Intrahepatic Cholestasis ◽  
First Trimester ◽  
Intrahepatic Cholestasis Of Pregnancy ◽  
Second Trimester ◽  
First Trimester Screening ◽  
Predictive Values ◽  
Second Trimester Screening ◽  
Trimester Screening ◽  
Β Hcg ◽  
Cholestasis Of Pregnancy

Objective: To assess the role of first and second-trimester screening biomarkers pregnancy-associated plasma protein-A(PAPP-A), free beta-human chorionic gonadotropin(free ß-hCG), estriol, alpha-fetoprotein and total β-hCG in the early diagnosis of intrahepatic cholestasis of pregnancy (ICP). Materials and Methods: Patients with ICP admitted to Mersin University Hospital for delivery between 2015 and 2019 and had first and second-trimester aneuploidy screening tests performed in the same facility were retrospectively assessed. Randomly 60 pregnant women without comorbid conditions during the same period were included as controls. Data regarding demographic characteristics, laboratory values including free ß-hCG and PAPP-A in first-trimester screening and total ß-hCG, estriol and alpha- fetoprotein in second-trimester screening were compared. Results: There were 46 eligible patients with ICP. In first trimester screening, it was found that PAPP-A MoM was significantly lower (0.89±0.55 vs. 1.94±0.73; p=0.035) while free ß-hCG MoM was significantly higher in ICP group when compared to controls (1.84±0.59 vs. 0.99±0.47; p=0.018). In second trimester screening, no significant difference was detected in aneuploidy markers between groups. For prediction of ICP development, first trimester free β-hCG >1.44 MoM was found to have a sensitivity of 50%, a specificity of 80% and positive and negative predictive values of 33% and 88.9% respectively. Similarly first trimester PAPP-A values <1.075 MoM was found to have 80% and 75% sensitivity and specificity with positive and negative predictive values of 75% and 44% respectively. Conclusion: Low PAPP-A MoM value and elevated free ß-hCG in first trimester seem to be associated with ICP development.

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