Determination of Median Values of First Trimester Screening Tests: A Tokat Scale Retrospective Study

Year 2019, Volume: 12 Issue: 2, 15 - 21, 29.12.2019

Muzaffer Katar

Abstract

Objectives:
The aim of this study was to determine the ability of maternal serum plasma
protein A (PAPP-A) and free beta-human chorionic gonadotropin (free ß-hCG)
values ​​measured in the first trimester screening test to predict the
complications that may develop in later gestational weeks, calculate the median
values ​​of these parameters and compare them with those of software we use.

Materials and methods:
The study included 16-46 years old women who applied to biochemistry laboratory
of Tokat Gaziosmanpasa University School of Medicine with gestational ages of 10
weeks and 6 days to 13 weeks and 6 days. The results of 3166 pregnant women were
evaluated retrospectively.

Results:
The mean age of the patients was 27.43 ± 5.46 and their weight was 65.66 ±
13.13 kilograms. Crown rump lengthes (CRL) were determined as 60.71 ± 8.56 mm.
Free ß-hCG levels were 55.1 ± 132.07 ng / mL and PAPP-A values ​​were 3683.53 ±
2486 mIU / l. Nuchal translucency measurements (NT) were determined as 1.38 ±
0.37mm. PAPP-A and Free ß-hCG MoM values ​​were 1.23 ± 0.68 and 1.23 ± 0.88,
respectively. New median values ​​of β-hCG were found to be significantly lower
than those of the program (p <0.05), while PAPP-A values ​​were
significantly higher (p <0.05).

Conclusion:
The accuracy and performance of first trimester screening tests should be
improved. Determination of median values ​​specific to the region and even to
the laboratory is now inevitable

Keywords

free ß-hCG, PAPP-A, Binary screening test

Supporting Institution

There are no institutions supporting our study

Thanks

We would like to thank our all of the staff, especially our data processing staff, for their valuable contributions in the collection and processing of data for this study.

Birinci Trimester Tarama Testlerinin Medyan Değerlerinin Belirlenmesi: Tokat Ölçekli Retrospektif Bir Çalışma

Abstract

Objectives:
The aim of this study was to determine the ability of maternal serum plasma
protein A (PAPP-A) and free beta-human chorionic gonadotropin (free ß-hCG)
values ​​measured in the first trimester screening test to predict the
complications that may develop in later gestational weeks, calculate the median
values ​​of these parameters and compare them with those of software we use.

Materials and methods:
The study included 16-46 years old women who applied to biochemistry laboratory
of Tokat Gaziosmanpasa University School of Medicine with gestational ages of 10
weeks and 6 days to 13 weeks and 6 days. The results of 3166 pregnant women were
evaluated retrospectively.

Results:
The mean age of the patients was 27.43 ± 5.46 and their weight was 65.66 ±
13.13 kilograms. Crown rump lengthes (CRL) were determined as 60.71 ± 8.56 mm.
Free ß-hCG levels were 55.1 ± 132.07 ng / mL and PAPP-A values ​​were 3683.53 ±
2486 mIU / l. Nuchal translucency measurements (NT) were determined as 1.38 ±
0.37mm. PAPP-A and Free ß-hCG MoM values ​​were 1.23 ± 0.68 and 1.23 ± 0.88,
respectively. New median values ​​of β-hCG were found to be significantly lower
than those of the program (p <0.05), while PAPP-A values ​​were
significantly higher (p <0.05).

Conclusion:
The accuracy and performance of first trimester screening tests should be
improved. Determination of median values ​​specific to the region and even to
the laboratory is now inevitable

Keywords

free ß-hCG, PAPP-A, Double screening test

References

• Referans1. Alp, H. H., Z. Huyut, E. Çokluk, M. R. Şekeroğlu and A. Tıbbi Biyokimya "İkili ve Üçlü Prenatal Tarama Testi Medyan Değerleri: Van Ölçekli Retrospektif Bir Çalışma." Turkish Journal of Biochemistry/Turk Biyokimya Dergisi 16(1).
• Referans2. Ananth, C. V., R. J. Wapner, S. Ananth, M. E. D’Alton and A. M. Vintzileos (2017). "First-trimester and second-trimester maternal serum biomarkers as predictors of placental abruption." Obstetrics and gynecology 129(3): 465.
• Referans3. Assessment, P. R. (2000). "Down syndrome: prenatal risk assessment and diagnosis." Am Fam Physician 62(4): 825-832.
• Referans4. Atak, P. G., A. Arpacı and G. Seydal (2014). "Adıyaman iline ait ikili ve üçlü prenatal tarama testlerinin medyan değerlerinin belirlenmesi." Turkish Journal of Biochemistry/Turk Biyokimya Dergisi 39(2).
• Referans5. Brizot, M. L., R. J. Snijders, N. A. Bersinger, P. Kuhn and K. H. Nicolaides (1994). "Maternal serum pregnancy-associated plasma protein A and fetal nuchal translucency thickness for the prediction of fetal trisomies in early pregnancy." Obstetrics and gynecology 84(6): 918-922.
• Referans6. Creasy, R. K., R. Resnik and J. D. Iams (2004). Maternal-fetal medicine: principles and practice, Gulf Professional Publishing.Cuckle, H. (2001). "Integrating antenatal Down's syndrome screening." Current Opinion in Obstetrics and Gynecology 13(2): 175-181.
• Referans7. Goetzl, L. (2002). "ACOG Committee on Practice Bulletins-Obstetrics. ACOG Practice Bulletin. Clinical Management Guideline for Obstetrician-Gynecologists Number 36, July 2002. Obstetric analgesia and anesthesia." Obstet Gynecol. 100: 177-191.
• Referans8. Holding, S. (1991). "Biochemical screening for Down's syndrome." BMJ: British Medical Journal 302(6787): 1275.
• Referans9. James, D., P. Steer, C. Weiner and B. Gonik (2008). "Yüksek Riskli Gebelikler Yönetim Seçenekleri." Erken prenatal bakım (Derleyen: Güner H), Güneş Tıp Kitabevleri, İstanbul 65.
• Referans10. Kagan, K. O., J. Sonek, P. Wagner and M. Hoopmann (2017). "Principles of first trimester screening in the age of non-invasive prenatal diagnosis: screening for chromosomal abnormalities." Archives of gynecology and obstetrics 296(4): 645-651.
• Referans11. Kappel, B., J. Nielsen, K. B. Hansen, M. Mikkelsen and A. J. Therkelsen (1987). "Spontaneous abortion following mid‐trimester amniocentesis. Clinical significance of placental perforation and blood‐stained amniotic fluid." BJOG: An International Journal of Obstetrics & Gynaecology 94(1): 50-54.
• Referans12. Marteau, T. M., R. Cook, J. Kidd, S. Michie, M. Johnston, J. Slack and R. W. Shaw (1992). "The psychological effects of false‐positive results in prenatal screening for fetal abnormality: a prospective study." Prenatal diagnosis 12(3): 205-214.
• Referans13. Nicolaides, K. H., G. Azar, D. Byrne, C. Mansur and K. Marks (1992). "Fetal nuchal translucency: ultrasound screening for chromosomal defects in first trimester of pregnancy." Bmj 304(6831): 867-869.
• Referans14. Spencer, K., J. Macri, D. Aitken and J. Connor (1992). "Free β-hCG as first-trimester marker for fetal trisomy." The Lancet 339(8807): 1480.
• Referans15. Sucu, V., S. Yıldırmak, M. Vardar and V. Mihmanlı "İkili ve Üçlü Tarama Testi Biyokimyasal Parametrelerinin Hastanemize Ait Medyanlarının Değerlendirilmesi." Abant Tıp Dergisi 7(2): 35-40.
• Referans16. Şanlı, D. B. and K. Kartkaya (2011). "Eskişehir Bölgesinde Üçlü Test Tarama Parametrelerinin Medyan Düzeylerinin Belirlenmesi." Turkish Journal of Biochemistry/Turk Biyokimya Dergisi 36(1).
• Referans17. Wald, N. and A. Hackshaw (1997). "Combining ultrasound and biochemistry in first‐trimester screening for Down's syndrome." Prenatal Diagnosis: Published in Affiliation With the International Society for Prenatal Diagnosis 17(9): 821-829.