The Predictive Value Of Prenatal Screening For Adverse Pregnancy Outcomes

Objective:To explore a technological system suitable for the Down's syndrome prenatal screening in some south province,using maternal serum markers.Methods:Five maternal serum markers,PAPP-A,AFP,Freeβ-hCG,μE3 and NT of 1118 cases were quantitatively detected by the time resolved fluorescent immunoassay technology。Results:(1) 80 cases in 1118 pregnant women were screened as high risk for Down's syndrome,and 1 was verified as trisomy 21 through prenatal diagnosis。(2) The normal medians of maternal serum markers on every gestational week in some south population were obtained。The medians of PAPP-A,AFP,Freeβ-hCG andμE3 have no significant differences(P＞0.05) between our population and those of Finnish and British population offered by PE company。(3)The incidences of spontaneous abortion,missed abortion,fetal malformation in the PAPP-A lower group were significantly higher than those of the control group between 9 and 13 gestational weeks.Oppositely,in the PAPP-A evaluated group,the incidences of pregnancy-induced hypertension and twin pregnancy were significantly higher than those in the control group;Between 14 and 21 gestational weeks;the incidences of missed abortion and intrauterine fetal demise in the AFP lower group were significantly higher than those of the control group,in the AFP evaluated group,the incidences of spontaneous abortion,missed abortion,fetal malformation,pregnancy-induced hypertension,twin pregnancy,twin pregnancy with one dead fetal were significantly higher than in the control group;Between 9 and 21 gestational weeks,in the Freeβ-hCG lower group,the incidences of spontaneous abortion,missed abortion,intrauterine fetal demise,fetal malformation were significantly higher than in the control group;In the Freeβ-hCG evaluated group,the incidences of fetal malformation,pregnancy- induced hypertension,twin pregnancy were significantly higher than in the control group。The incidences of intrauterine growth restriction,intrauterine fetal demise,fetal malformation,pregnancy-induced hypertension,twin pregnancy with one dead fetal in theμE3 lower group were significantly higher than those of the control group;the incidences of spontaneous abortion,fetal malformation,twin pregnancy with one dead fetal in the NT lower group were significantly higher than those of the control group between 9 and 13 gestational weeks.Conclusions:(1) The medians and normal reference intervals of maternal serum markers:PAPP-A,AFP,Freeβ-hCG andμE3 of each gestational week in some south population were established,offering reference data for other local prenatal screening programs。(2) Excessive higher or lower values of PAPP-A,AFP,Freeβ-hCG,μE3 and NT imply certain abnormal pregnancies,and the test results will be benefit to clinical prognostic evaluation。(3) Combined test of PAPP-A,AFP,Freeβ-hCG,μE3 and NT may be an effective and easily-accepted technique for Down's syndrome screening to the first trimester and second trimester pregnant women。...