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Yıl 2015, Cilt: 5 Sayı: 1, 8 - 12, 04.03.2015

Bülent Çakmak , Zeki Özsoy Fulya Metin Mehmet Nacar Selim Gülücü İsmail Sağ

https://doi.org/10.16899/ctd.26653

Öz

Objective: The aim of this study was to evaluate the findings of second trimester fetal anatomic ultrasound scan in pregnant women with high level Alpha Feto Protein (AFP) in triple test. Methods: Triple test results of 8552 pregnant women were evaluated in a university hospital between January 2011 and December 2013. Fetal anatomic ultrasound scan results of pregnant women who had AFP level ≥2.5 multiples of median (MoM) in triple test were investigated for presence of pathologic findings. Results: AFP levels were detected over 2.5 MoM in 122 (1.14%) of 8552 pregnant women. There were no pathologic findings in 85.2% (104/122) of cases, but 14.8% (18/122) of cases had pathologic results; neural tube defect (NTD) 9% (11/122) and anhidroamnios 2.5% (3/122). Omphalocele, polycystic kidney, sacrococcygeal teratoma, placental chorangioma were detected in 0.8% ratio. NTDs were found in 11 (0.12%) of 8552 pregnant women who evaluated for maternal serum AFP (MSAFP). Conclusion: The routine use of MSAFP may be queried in NTD screening due to common usage of sufficient fetal anatomic ultrasound scan

Anahtar Kelimeler

Alpha feto protein neural tube defects ultrasound anomaly

Kaynakça

  • Knoshnood B, Greenlees R, Loane M, et al; EUROCAT Project Management Committee; EUROCAT Working Group. Paper 2: EUROCAT public health indicators for congenital anomalies in Europe. Birth Defects Res A Clin Mol Teratol 2011;91(Suppl 1):16-22.
  • Tortori-Donati P, Rossi A, Cama A. Spinal dysraphism: a review of neuroradiological features with embryological correlations and proposal for a new classification. Neuroradiology 2000;42:471-91.
  • Krantz DA, Hallahan TW, Sherwin JE. Screening for open neural tube defects. Clin Lab Med 2010;30:721-5.
  • Bradley LA, Palomaki GE, McDowell GA; ONTD Working Group, and ACMG Laboratory Quality Assurance Committee. Technical standards and guidelines: prenatal screening for open neural tube defects. Genet Med 2005;7:355-69.
  • Cameron M, Moran P. Prenatal screening and diagnosis of neural tube defects. Prenat Diagn 2009;29:402-11.
  • Agopian AJ, Canfield MA, Olney RS, et al, and the National Birth Defects Prevention Study. Spina bifida subtypes and sub-phenotypes by maternal race/ethnicity in the national birth defects prevention study. Am J Med Genet 2011;158:109-15.
  • Jaruratanasirikul S, Kor-anantakul O, Limpitikul W, et al. Prevalence of neural tube defect in southern Thailand: a population-based survey during 2009–2012. Childs Nerv Syst 2014;DOI 10.1007/s00381-014-2410-y (in press).
  • Tunçbilek E, Boduroğlu K, Alikaşifoğlu M. Neural tube defects in Turkey: prevalence, distribution and risk factors. Turk J Pediatr 1999;41:299-305.
  • Ergin T. İkinci trimester fetal anomali tarama testleri. Çiçek N (Editör). Riskli Gebelikler. Kadın Hastalıkları ve Doğum Bilgisi. 2. baskı. Ankara: Güneş Kitabevi, 2006:399-410.
  • Wang ZP, Li H, Hao LZ, et al. The effectiveness of prenatal serum biomarker screening for neural tube defects in second trimester pregnant women: a meta-analysis. Prenat Diagn 2009;29:960-5.
  • Szajkowski TP, Chodirker BN, MacDonald KM, et al. Maternal serum alpha-fetoprotein levels in fetal hydrocephalus: a retrospective population based study. BMC Pregnancy and Childbirth 2006;6:23.
  • Boyd PA, Devigan C, Khoshnood B, et al, EUROCAT Working Group. Survey of prenatal screening policies in Europe for structural malformations and chromosome anomalies, and their impact on detection and termination rates for neural tube defects and Down’s syndrome. BJOG: Int J Obstet Gynaecol 2008;115:689-96.
  • Taipale P, Ammala M, Salonen R, et al. Learning curve in ultrasonographic screening for selected fetal structural anomalies in early pregnancy. Obstet Gynecol 2003;101:273-8.
  • Whitlow BJ, Chatzipapas IK, Lazanakis ML, et al. The value of sonography in early pregnancy for the detection of fetal abnormalities in an unselected population. Br J Obstet Gynaecol 1999;106:929-36.
  • Grandjean H, Larroque D, Levi S. The performance of routine ultrasonographic screening of pregnancies in the Eurofetus Study. Am J Obstet Gynecol 1999;181:446-54.
  • Smith NC, Hau C. A six year study of the antenatal detection of fetal abnormality in six Scottish health boards. Br J Obstet Gynaecol 1999;106:206-12.
  • Chaoui R, Benoit B, Mitkowska-Wozniak H, et al. Assessment of intracranial translucency (IT) in the detection of spina bifida at the 11–13-week scan. Ultrasound Obstet Gynecol 2009;34:249-52.
  • Loureiro T, Ushakov F, Montenegro N, et al. Cerebral ventricular system in fetuses with open spina bifida at 11–13 weeks’ gestation. Ultrasound Obstet Gynecol 2012;39:620-4.
  • Mangione R, Dhombres F, Lelong N, et al. Screening for fetal spina bifida at the 11–13-week scan using three anatomical features of the posterior brain. Ultrasound Obstet Gynecol 2013;42:416-20.
  • Gagnon A, Wilson RD, Audibert F, et al. Obstetrical complications associated with abnormal maternal serum markers analytes. J Obstet Gyneacol Can 2008;30:918-49.
  • Milunsky A, Jick SS, Bruell CL, et al. Predictive values, relative risks, and overall benefits of high and low maternal serum alpha-fetoprotein screening in singleton pregnancies: new epidemiologic data. Am J Obstet Gynecol 1989;161:291-7.
  • McPherson E, Thomas GT, Manlick C, et al. Extreme values of maternal serum analytes in second trimester screening: looking beyond trisomy and NTD’s. J Genet Counsel 2011;20:396-403.
  • Androusopouls G, Gkogko P, Decvalas G. Mid-trimester maternal serum hCG and Alpha Feta Protein levels clinical significance and prediction of adverse pregnancy outcome. Int J Endocrino Metabol 2013;11:102-6.
  • Özgünen T, Evrüke C, Kadayıfçı O, ve ark. 170 riskli gebede açık nöral tüp defekti taramasında maternal serum alfa fetoprotein sonuçları. Perinatoloji Dergisi 1994;2:248-50.
  • Erhan G, Yücebilgin MS, Bilgin O, ve ark. Gebelerde alfafetoprotein düzeyleri ve nöral tüp defektleri. Turkiye Klinikleri J Gynecol Obst 1994;4:74-7.
  • Kabukçu A, Önderoğlu L, Durukan T, ve ark. İkinci trimesterde anne serumunda açıklanamayan alfafetoprotein yüksekliğinin gebeliğin sonucuna etkisi. Turkiye Klinikleri J Gynecol Obst 1996;6:287-9.

İkinci Trimester Gebeliklerde Maternal Serum Alfa Feto Protein (AFP) Yüksekliği ve Ultrasonografi Bulguları

Yıl 2015, Cilt: 5 Sayı: 1, 8 - 12, 04.03.2015

Bülent Çakmak , Zeki Özsoy Fulya Metin Mehmet Nacar Selim Gülücü İsmail Sağ

https://doi.org/10.16899/ctd.26653

Öz

Amaç: Bu çalışmanın amacı üçlü testte Alfa Feto Protein (AFP) yüksekliği saptanan gebelerde ikinci trimester ayrıntılı ultrasonografi bulgularının irdelenmesidir.

Yöntem: Ocak 2011 - Aralık 2013 tarihleri arasında bir üniversite hastanesi gebe polikliniğinde üçlü test yapılan 8552 gebenin test sonuçları değerlendirildi. Üçlü test sonucunda AFP değeri ≥2.5 multiples of median (MoM) çıkan gebelerin ikinci düzey (ayrıntılı) ultrasonografi sonuçları patolojik bulguların varlığı açısından değerlendirildi.

Bulgular: Değerlendirmeye alınan 8552 gebenin 122(%1.14)'sinde AFP değeri 2.5 MoM üzerinde saptandı. İkinci düzey ultrasonografide olguların %85.2 (104/122)'inde patoloji saptanmazken %14.8 (18/122)'sinde patolojik bulgu tespit edildi; %9 (11/122)'sinde nöral tüp defekti (NTD) (Chiary tip-II) ve %2.5 (3/122)'sinde anhidroamnios saptandı. Omfalosel, polikistik böbrek, sakrokoksigeal teratom ve plasental koranjioma ise %0.8 oranında saptandı. Maternal serum AFP (MSAFP) değerlendirilmesi yapılan 8552 gebenin 11'inde (%0.12) NTD saptandı.

Sonuç: Yeterli ultrasonografik anatomik incelemenin yaygın olarak yapılması nedeniyle fetal NTD taramasında MSAFP'nin rutin kullanımı sorgulanabilir.

 

Anahtar Kelimeler

Alfa feto protein nöral tüp defekti ultrasonografi anomali

Kaynakça

  • Knoshnood B, Greenlees R, Loane M, et al; EUROCAT Project Management Committee; EUROCAT Working Group. Paper 2: EUROCAT public health indicators for congenital anomalies in Europe. Birth Defects Res A Clin Mol Teratol 2011;91(Suppl 1):16-22.
  • Tortori-Donati P, Rossi A, Cama A. Spinal dysraphism: a review of neuroradiological features with embryological correlations and proposal for a new classification. Neuroradiology 2000;42:471-91.
  • Krantz DA, Hallahan TW, Sherwin JE. Screening for open neural tube defects. Clin Lab Med 2010;30:721-5.
  • Bradley LA, Palomaki GE, McDowell GA; ONTD Working Group, and ACMG Laboratory Quality Assurance Committee. Technical standards and guidelines: prenatal screening for open neural tube defects. Genet Med 2005;7:355-69.
  • Cameron M, Moran P. Prenatal screening and diagnosis of neural tube defects. Prenat Diagn 2009;29:402-11.
  • Agopian AJ, Canfield MA, Olney RS, et al, and the National Birth Defects Prevention Study. Spina bifida subtypes and sub-phenotypes by maternal race/ethnicity in the national birth defects prevention study. Am J Med Genet 2011;158:109-15.
  • Jaruratanasirikul S, Kor-anantakul O, Limpitikul W, et al. Prevalence of neural tube defect in southern Thailand: a population-based survey during 2009–2012. Childs Nerv Syst 2014;DOI 10.1007/s00381-014-2410-y (in press).
  • Tunçbilek E, Boduroğlu K, Alikaşifoğlu M. Neural tube defects in Turkey: prevalence, distribution and risk factors. Turk J Pediatr 1999;41:299-305.
  • Ergin T. İkinci trimester fetal anomali tarama testleri. Çiçek N (Editör). Riskli Gebelikler. Kadın Hastalıkları ve Doğum Bilgisi. 2. baskı. Ankara: Güneş Kitabevi, 2006:399-410.
  • Wang ZP, Li H, Hao LZ, et al. The effectiveness of prenatal serum biomarker screening for neural tube defects in second trimester pregnant women: a meta-analysis. Prenat Diagn 2009;29:960-5.
  • Szajkowski TP, Chodirker BN, MacDonald KM, et al. Maternal serum alpha-fetoprotein levels in fetal hydrocephalus: a retrospective population based study. BMC Pregnancy and Childbirth 2006;6:23.
  • Boyd PA, Devigan C, Khoshnood B, et al, EUROCAT Working Group. Survey of prenatal screening policies in Europe for structural malformations and chromosome anomalies, and their impact on detection and termination rates for neural tube defects and Down’s syndrome. BJOG: Int J Obstet Gynaecol 2008;115:689-96.
  • Taipale P, Ammala M, Salonen R, et al. Learning curve in ultrasonographic screening for selected fetal structural anomalies in early pregnancy. Obstet Gynecol 2003;101:273-8.
  • Whitlow BJ, Chatzipapas IK, Lazanakis ML, et al. The value of sonography in early pregnancy for the detection of fetal abnormalities in an unselected population. Br J Obstet Gynaecol 1999;106:929-36.
  • Grandjean H, Larroque D, Levi S. The performance of routine ultrasonographic screening of pregnancies in the Eurofetus Study. Am J Obstet Gynecol 1999;181:446-54.
  • Smith NC, Hau C. A six year study of the antenatal detection of fetal abnormality in six Scottish health boards. Br J Obstet Gynaecol 1999;106:206-12.
  • Chaoui R, Benoit B, Mitkowska-Wozniak H, et al. Assessment of intracranial translucency (IT) in the detection of spina bifida at the 11–13-week scan. Ultrasound Obstet Gynecol 2009;34:249-52.
  • Loureiro T, Ushakov F, Montenegro N, et al. Cerebral ventricular system in fetuses with open spina bifida at 11–13 weeks’ gestation. Ultrasound Obstet Gynecol 2012;39:620-4.
  • Mangione R, Dhombres F, Lelong N, et al. Screening for fetal spina bifida at the 11–13-week scan using three anatomical features of the posterior brain. Ultrasound Obstet Gynecol 2013;42:416-20.
  • Gagnon A, Wilson RD, Audibert F, et al. Obstetrical complications associated with abnormal maternal serum markers analytes. J Obstet Gyneacol Can 2008;30:918-49.
  • Milunsky A, Jick SS, Bruell CL, et al. Predictive values, relative risks, and overall benefits of high and low maternal serum alpha-fetoprotein screening in singleton pregnancies: new epidemiologic data. Am J Obstet Gynecol 1989;161:291-7.
  • McPherson E, Thomas GT, Manlick C, et al. Extreme values of maternal serum analytes in second trimester screening: looking beyond trisomy and NTD’s. J Genet Counsel 2011;20:396-403.
  • Androusopouls G, Gkogko P, Decvalas G. Mid-trimester maternal serum hCG and Alpha Feta Protein levels clinical significance and prediction of adverse pregnancy outcome. Int J Endocrino Metabol 2013;11:102-6.
  • Özgünen T, Evrüke C, Kadayıfçı O, ve ark. 170 riskli gebede açık nöral tüp defekti taramasında maternal serum alfa fetoprotein sonuçları. Perinatoloji Dergisi 1994;2:248-50.
  • Erhan G, Yücebilgin MS, Bilgin O, ve ark. Gebelerde alfafetoprotein düzeyleri ve nöral tüp defektleri. Turkiye Klinikleri J Gynecol Obst 1994;4:74-7.
  • Kabukçu A, Önderoğlu L, Durukan T, ve ark. İkinci trimesterde anne serumunda açıklanamayan alfafetoprotein yüksekliğinin gebeliğin sonucuna etkisi. Turkiye Klinikleri J Gynecol Obst 1996;6:287-9.
Toplam 26 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Orjinal Çalışma
Yazarlar

Bülent Çakmak

Zeki Özsoy Bu kişi benim

Fulya Metin Bu kişi benim

Mehmet Nacar Bu kişi benim

Selim Gülücü Bu kişi benim

İsmail Sağ Bu kişi benim

Yayımlanma Tarihi 4 Mart 2015
Yayımlandığı Sayı Yıl 2015 Cilt: 5 Sayı: 1

Kaynak Göster

APA Çakmak, B., Özsoy, Z., Metin, F., Nacar, M., vd. (2015). İkinci Trimester Gebeliklerde Maternal Serum Alfa Feto Protein (AFP) Yüksekliği ve Ultrasonografi Bulguları. Çağdaş Tıp Dergisi, 5(1), 8-12. https://doi.org/10.16899/ctd.26653
AMA Çakmak B, Özsoy Z, Metin F, Nacar M, Gülücü S, Sağ İ. İkinci Trimester Gebeliklerde Maternal Serum Alfa Feto Protein (AFP) Yüksekliği ve Ultrasonografi Bulguları. J Contemp Med. Mart 2015;5(1):8-12. doi:10.16899/ctd.26653
Chicago Çakmak, Bülent, Zeki Özsoy, Fulya Metin, Mehmet Nacar, Selim Gülücü, ve İsmail Sağ. “İkinci Trimester Gebeliklerde Maternal Serum Alfa Feto Protein (AFP) Yüksekliği Ve Ultrasonografi Bulguları”. Çağdaş Tıp Dergisi 5, sy. 1 (Mart 2015): 8-12. https://doi.org/10.16899/ctd.26653.
EndNote Çakmak B, Özsoy Z, Metin F, Nacar M, Gülücü S, Sağ İ (01 Mart 2015) İkinci Trimester Gebeliklerde Maternal Serum Alfa Feto Protein (AFP) Yüksekliği ve Ultrasonografi Bulguları. Çağdaş Tıp Dergisi 5 1 8–12.
IEEE B. Çakmak, Z. Özsoy, F. Metin, M. Nacar, S. Gülücü, ve İ. Sağ, “İkinci Trimester Gebeliklerde Maternal Serum Alfa Feto Protein (AFP) Yüksekliği ve Ultrasonografi Bulguları”, J Contemp Med, c. 5, sy. 1, ss. 8–12, 2015, doi: 10.16899/ctd.26653.
ISNAD Çakmak, Bülent vd. “İkinci Trimester Gebeliklerde Maternal Serum Alfa Feto Protein (AFP) Yüksekliği Ve Ultrasonografi Bulguları”. Çağdaş Tıp Dergisi 5/1 (Mart 2015), 8-12. https://doi.org/10.16899/ctd.26653.
JAMA Çakmak B, Özsoy Z, Metin F, Nacar M, Gülücü S, Sağ İ. İkinci Trimester Gebeliklerde Maternal Serum Alfa Feto Protein (AFP) Yüksekliği ve Ultrasonografi Bulguları. J Contemp Med. 2015;5:8–12.
MLA Çakmak, Bülent vd. “İkinci Trimester Gebeliklerde Maternal Serum Alfa Feto Protein (AFP) Yüksekliği Ve Ultrasonografi Bulguları”. Çağdaş Tıp Dergisi, c. 5, sy. 1, 2015, ss. 8-12, doi:10.16899/ctd.26653.
Vancouver Çakmak B, Özsoy Z, Metin F, Nacar M, Gülücü S, Sağ İ. İkinci Trimester Gebeliklerde Maternal Serum Alfa Feto Protein (AFP) Yüksekliği ve Ultrasonografi Bulguları. J Contemp Med. 2015;5(1):8-12.