Prenatal Screening Test Parameters Can Be Affected By Either Placental Location Or Fetal Gender

Abstract

Aim: This study aims to investigate the relationship between first and second trimester screening test parameters and placental location together with fetal gender.Material and Methods: Fetal nuchal translucency NT measurement and maternal serum free beta human chorionic gonadotropin b-HCG and pregnancy-associated plasma protein-A PAPP-A values in the first trimester and maternal serum alpha-fetoprotein AFP , human chorionic gonadotropin hCG and unconjugated estriol uE3 levels in the second trimester were determined and compared to fetal gender and placental location for demonstrating the relationship between them.Results: NT values were higher among female fetuses p= 0.04 . AFP values were signifi-cantly higher in the posterior placenta group p= 0.04 , and first trimester hCG values were higher in the posterior placenta group with a borderline level of significance p = 0.05 .Conclusion: First and second trimester screening test parameters can be affected by fetal gender and placental location.

Keywords

• Prenatal screening tests,fetal gender,placental location,placenta

Prenatal Tarama Test Parametreleri Plasental Lokalizasyon Yada Fetal Cinsiyetten Etkilenebilir

Abstract

Amaç: Bu çalışma ilk trimester ve ikinci trimester tarama testi parametreleri ile plasental lokalizasyon ve fetal gender arasında ilşki olup olmadığını araştırmaktadır.Gereç ve Yöntemler: Fetal ense kalınlığı NT ölçümü ve ilk trimester maternal serum serbest beta human koryonik gonadotropin b-HCG , pregnancy-associated plasma pro-tein-A PAPP-A değerleri ile ikinci trimester maternal serum alfa-fetoprotein AFP , human koryonik gonadotropin hCG and ankonjuge estriol uE3 düzeyleri tesbit edildi ve fetal cinsiyet ve plasenta lokalizastonu ile ilişkisini göstermek için karşılaştırıldı.Bulgular: Kız fetuslarda NT değerleri daha yüksekti p= 0.04 . Posterior plasenta grubunda AFP değerleri anlamlı bir şekilde yüksek idi p= 0.04 , ve ilk trimester hCG değerleri posterior plasenta grubunda sınırda anlamlılık gösterdi p = 0.05 .Sonuç: İlk trimester ve ikinci trimester tarama test parametreleri fetal cinsiyet ve plasenta likalizasyonundan etkilenebilir.

Keywords

• Prenatal tarama testleri,fetal cinsiyet,plasental lokalizasyon,plasenta

References

1. Cheng EY, Luthy DA, Zebelman AM, Williams MA, Lieppman RE, Hickok DE. A prospective evaluation of a second-trimester screening test for fetal Down syndrome using maternal serum alpha-fetoprotein, hCG, and unconjugated estriol. Obstet Gynecol. 1993 ; 81 : 72 - 77.
2. İbrahim, K. A. L. E., Gulerman HC, Moralioglu Ö, Gurlek B, Yenicesu O, Sarikaya E, Ergocen S. İlk Trimester Düşük PAPP-A Düzeyleri ile Gebelik Komplikasyonları Arasındaki İlişki. Turkiye Klinikleri Journal of Gynecolo- gy and Obstetrics, 2012; 22: 25-35.
3. Sarıkaya E. Maternal Characteristics and Perinatal Outcome of Babies Born with Isolated Congenital Ichthyosis: 3 Years of Experience in a Med- ical Center. Yeni Tıp Dergisi 2012; 29: 218.
4. Sarıkaya E, Bozdağ S, Deveer R, Suna Oğuz S, Dilmen U, Mollamahmu- toglu, L. Possible association of medications during pregnancy with low estriol level of the triple antenatal screening test. The Journal of Mater- nal-Fetal & Neonatal Medicine 2012; 25.7: 930-933.
5. Yaron Y, Lehavi O, Orr-Urtreger A, Gull I, Lessing JB, Amit A, Ben-Yosef D. Maternal serum HCG is higher in the presence of a female fetus as early as week 3 post-fertilization. Hum Reprod. 2002; 17: 485-9.
6. Chapman MG, Furness ET, Jones WR, Sheat JH. Significance of the ultra- sound location of placental site in early pregnancy. Br J Obstet Gynaecol. 1979; 86: 846 - 8.
7. Antsaklis A, Daskalakis G, Tzortzis E, Michalas S.The effect of gesta- tional age and placental location on the prediction of pre-eclampsia by uterine artery Doppler velocimetry in low-risk nulliparous women. Ultra- sound Obstet Gynecol. 2000; 16: 635 - 9.
8. Hasegawa J, Sekizawa A, Farina A, Nakamura M, Matsuoka R, Ichizuka K, Okai T. Location of the placenta or the umbilical cord insertion site in the lowest uterine segment is associated with low maternal blood pres- sure. BJOG. 2011; 118: 1464 - 9.

9. Kofinas AD, Penry M, Swain M, Hatjis CG. Effect of placental laterality on uterine artery resistance and development of preeclampsia and intrauter- ine growth retardation. Am J Obstet Gynecol. 1989; 161: 1536 - 9.
10. Gonser M, Tillack N, Pfeiffer KH, Mielke G. Placental location and inci- dence of pre-eclampsia. Ultraschall Med. 1996; 17: 236 - 8.
11. Kalanithi LE, Illuzzi JL, Nossov VB, Frisbaek Y, Abdel-Razeq S, Copel JA, Norwitz ER. Intrauterine growth restriction and placental location. J Ultra- sound Med. 2007; 26: 1481 - 9
12. Buambo-Bamanga SF, Oyere-Moke P, Makoumbou P, Ekoundzola JR, Mayanda HF. Placenta previa: maternal and fetal prognosis covering 128 consecutive cases from the Brazzaville University Hospital Center. Sante. 2004; 14: 177 - 81.
13. Ghourab S. Third-trimester transvaginal ultrasonography in placenta pre- via: does the shape of the lower placental edge predict clinical outcome? Ultrasound Obstet Gynecol. 2001; 18: 103 - 8.
14. Gardberg M, Tuppurainen M . Anterior placental location predisposes for occiput posterior presentation near term. Acta Obstet Gynecol Scand. 1994; 73: 151 - 2.
15. Silver RK, MacGregor SN, Sholl JS, Elesh RH, Beaird JA, Waldee JK.Ini- tiating a chorionic villus sampling program. Relying on placental location as the primary determinant of the sampling route. J Reprod Med. 1990; 35: 964 - 8.
16. Jang DG, We JS, Shin JU, Choi YJ, Ko HS, Park IY, Shin JC.Maternal outcomes according to placental position in placental previa. Int J Med Sci. 2011; 8: 439 – 44.
17. Jang DG, Jo YS, Lee SJ, Lee GS. Risk factors of neonatal anemia in placenta previa. Int J Med Sci. 2011; 8: 554 – 7.
18. Sowers SG, Reish RL, Burton BK. Fetal sex-related differences in mater- nal serum a-fetoprotein during the second trimester of pregnancy. Am J Obstet Gynecol 1983; 146: 786 - 9.
19. de Graaf IM, Cuckle HS, Pajkrt E, Leschot NJ, Bleker OP, van Lith JM. Co-variables in first trimester maternal serum screening. Prenat. Diagn. 2000; 20: 186 -189
20. Spencer K, Muller F, Aitken DA. Biochemical markers of trisomy 21 in amniotic fluid. Prenat Diagn 1997; 17: 31 - 7.
21. Spencer K. The influence of fetal sex in screening for trisomy 21 by fetal nuchal translucency, maternal serum free b-hCG and PAPP-A at 10-14 weeks of gestation Prenat Diagn 2000; 20: 673 - 675.
22. Magann EF, Evans SF, Newnham JPPlacental implantation at 18 weeks and migration throughout pregnancy. South Med J. 1998; 91: 1025 - 7.
23. Sekiguchi A, Nakai A, Kawabata I, Hayashi M, Takeshita T. Type and loca- tion of placenta previa affect preterm delivery risk related to antepartum hemorrhage. Int J Med Sci. 2013; 24: 1683 - 8.