Lack of correlation between elevated maternal serum hCG during second-trimester biochemical screening and fetal congenital anomaly
Objective Isolated elevations in midtrimester maternal serum human chorionic gonadotrophin concentrations (MShCG) have been reported to be associated with a substantially increased likelihood of fetal congenital malformations. The reported malformations included a wide range of organ systems, origin...
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| Veröffentlicht in: | Prenatal diagnosis 2005-03, Vol.25 (3), p.220-224 |
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| creator | Celentano, Claudio Guanciali-Franchi, Paolo Emilio Liberati, Marco Palka, Chiara Fantasia, Donatella Morizio, Elisena Calabrese, Giuseppe Stuppia, Liborio Rotmensch, Siegfried |
| description | Objective
Isolated elevations in midtrimester maternal serum human chorionic gonadotrophin concentrations (MShCG) have been reported to be associated with a substantially increased likelihood of fetal congenital malformations. The reported malformations included a wide range of organ systems, originating at different embryologic developmental stages. The purpose of our study was to determine the significance of an isolated elevated MShCG (>2.5 MoM) in midtrimester for the detection of fetal structural anomalies in a large population.
Methods
Among 10 144 women who underwent a biochemical triple screen at 15 to 18 weeks' gestation, 463 patients, who had an elevated MShCG, but normal α‐fetoprotein (AFP) and unconjugated estriol (uE3) levels, were identified. Patients with an integrated calculated Down syndrome risk above 1:250 were excluded. Only nonsmokers, at ages |
| doi_str_mv | 10.1002/pd.1110 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_67702786</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>67702786</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3830-203e4bc2fe38af3f9de67df2c6c0c391528bd5cd8d6ed57a20c7665708aa3aa83</originalsourceid><addsrcrecordid>eNp10E1v1DAQBmALUdGlIP4B8gU4oBR_ENs5VgtsK1aA-BBHa2JP2tAkXuyEstf-8jraiJ642Nbo0YznJeQZZ6ecMfFm50855-wBWXFW6YIJIR-SFeP5LU3Jj8njlH5laESlH5FjXuqKKyVX5HYL7pqGhroQI3YwtmGgNY43iAPFDv_AiJ72-YwDdDRhnHp6td5QP8V2uMwFFwZfjLHtMWVE6za4K-xbN2sXc5uZweBpg2OuZX6Za_MThtBDt39CjhroEj5d7hPy48P77-vzYvt5c7E-2xZOGskKwSS-rZ1oUBpoZFN5VNo3winHnKx4KUztS-eNV-hLDYI5rVSpmQGQAEaekJeHvrsYfk_5t7Zvk8OugwHDlKzSmgltVIavDtDFkFLExu7yehD3ljM7x2133s5xZ_l8aTnVPfp7t-SbwYsFQMqJNBEG16Z7p5QSvJwbvT64m7bD_f_m2S_vlrHFQbc58r__NMTrvITUpf35aWPl9hv7eq4-WiPvACRhpp0</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>67702786</pqid></control><display><type>article</type><title>Lack of correlation between elevated maternal serum hCG during second-trimester biochemical screening and fetal congenital anomaly</title><source>MEDLINE</source><source>Wiley Online Library Journals</source><creator>Celentano, Claudio ; Guanciali-Franchi, Paolo Emilio ; Liberati, Marco ; Palka, Chiara ; Fantasia, Donatella ; Morizio, Elisena ; Calabrese, Giuseppe ; Stuppia, Liborio ; Rotmensch, Siegfried</creator><creatorcontrib>Celentano, Claudio ; Guanciali-Franchi, Paolo Emilio ; Liberati, Marco ; Palka, Chiara ; Fantasia, Donatella ; Morizio, Elisena ; Calabrese, Giuseppe ; Stuppia, Liborio ; Rotmensch, Siegfried</creatorcontrib><description>Objective
Isolated elevations in midtrimester maternal serum human chorionic gonadotrophin concentrations (MShCG) have been reported to be associated with a substantially increased likelihood of fetal congenital malformations. The reported malformations included a wide range of organ systems, originating at different embryologic developmental stages. The purpose of our study was to determine the significance of an isolated elevated MShCG (>2.5 MoM) in midtrimester for the detection of fetal structural anomalies in a large population.
Methods
Among 10 144 women who underwent a biochemical triple screen at 15 to 18 weeks' gestation, 463 patients, who had an elevated MShCG, but normal α‐fetoprotein (AFP) and unconjugated estriol (uE3) levels, were identified. Patients with an integrated calculated Down syndrome risk above 1:250 were excluded. Only nonsmokers, at ages <35 years, without a history of prior fetal anomalies were included. The control group consisted of 463 patients with normal serum analyte concentrations and Down syndrome risks below 1:250, who were matched for maternal age and date of biochemical screen. All patients underwent a detailed genetic sonogram in which an anatomic survey and multiple ‘soft markers’ for aneuploidy were looked for. Newborns were examined by a senior pediatrician trained in dysmorphology.
Results
MShCG levels were 3.18 ± 0.72 versus 0.99 ± 0.43 MoM (p < 0.0001) in study and control groups respectively. Sonography revealed 8 versus 6 cases of major congenital anomalies among the 463 patients of their respective groups, and 39 versus 36 sonographic ‘soft markers’ for aneuploidy. Fetal karyotyping and neonatal examination for dysmorphology revealed 6 chromosomal anomalies (4 Down syndrome; 2 Turner syndrome) among the 8 major malformations in the study group, but none in the controls (p < 0.0001). Three of the 39 fetuses with ‘soft markers’ and elevated MShCG were found to have trisomy 21.
Conclusion
Isolated elevation of MShCG does not confer an increased risk of fetal congenital anomalies other than chromosomal abnormalities. However, elevated MShCG levels in combination with sonographic ‘soft markers’ for aneuploidy were associated with a high incidence of chromosomal anomalies, despite a normal biochemical triple screen risk estimate. Copyright © 2005 John Wiley & Sons, Ltd.</description><identifier>ISSN: 0197-3851</identifier><identifier>EISSN: 1097-0223</identifier><identifier>DOI: 10.1002/pd.1110</identifier><identifier>PMID: 15791663</identifier><identifier>CODEN: PRDIDM</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Ltd</publisher><subject>Adult ; Biological and medical sciences ; Birth control ; Chorionic Gonadotropin - blood ; Congenital Abnormalities - blood ; congenital anomaly risk ; elevated serum hCG ; Female ; Fetal Diseases - blood ; Gynecology. Andrology. Obstetrics ; Hormonal contraception ; Humans ; Mass Screening ; Medical sciences ; Pregnancy ; Pregnancy Trimester, Second</subject><ispartof>Prenatal diagnosis, 2005-03, Vol.25 (3), p.220-224</ispartof><rights>Copyright © 2005 John Wiley & Sons, Ltd.</rights><rights>2005 INIST-CNRS</rights><rights>Copyright 2005 John Wiley & Sons, Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3830-203e4bc2fe38af3f9de67df2c6c0c391528bd5cd8d6ed57a20c7665708aa3aa83</citedby><cites>FETCH-LOGICAL-c3830-203e4bc2fe38af3f9de67df2c6c0c391528bd5cd8d6ed57a20c7665708aa3aa83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fpd.1110$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fpd.1110$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1416,27922,27923,45572,45573</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16662150$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15791663$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Celentano, Claudio</creatorcontrib><creatorcontrib>Guanciali-Franchi, Paolo Emilio</creatorcontrib><creatorcontrib>Liberati, Marco</creatorcontrib><creatorcontrib>Palka, Chiara</creatorcontrib><creatorcontrib>Fantasia, Donatella</creatorcontrib><creatorcontrib>Morizio, Elisena</creatorcontrib><creatorcontrib>Calabrese, Giuseppe</creatorcontrib><creatorcontrib>Stuppia, Liborio</creatorcontrib><creatorcontrib>Rotmensch, Siegfried</creatorcontrib><title>Lack of correlation between elevated maternal serum hCG during second-trimester biochemical screening and fetal congenital anomaly</title><title>Prenatal diagnosis</title><addtitle>Prenat. Diagn</addtitle><description>Objective
Isolated elevations in midtrimester maternal serum human chorionic gonadotrophin concentrations (MShCG) have been reported to be associated with a substantially increased likelihood of fetal congenital malformations. The reported malformations included a wide range of organ systems, originating at different embryologic developmental stages. The purpose of our study was to determine the significance of an isolated elevated MShCG (>2.5 MoM) in midtrimester for the detection of fetal structural anomalies in a large population.
Methods
Among 10 144 women who underwent a biochemical triple screen at 15 to 18 weeks' gestation, 463 patients, who had an elevated MShCG, but normal α‐fetoprotein (AFP) and unconjugated estriol (uE3) levels, were identified. Patients with an integrated calculated Down syndrome risk above 1:250 were excluded. Only nonsmokers, at ages <35 years, without a history of prior fetal anomalies were included. The control group consisted of 463 patients with normal serum analyte concentrations and Down syndrome risks below 1:250, who were matched for maternal age and date of biochemical screen. All patients underwent a detailed genetic sonogram in which an anatomic survey and multiple ‘soft markers’ for aneuploidy were looked for. Newborns were examined by a senior pediatrician trained in dysmorphology.
Results
MShCG levels were 3.18 ± 0.72 versus 0.99 ± 0.43 MoM (p < 0.0001) in study and control groups respectively. Sonography revealed 8 versus 6 cases of major congenital anomalies among the 463 patients of their respective groups, and 39 versus 36 sonographic ‘soft markers’ for aneuploidy. Fetal karyotyping and neonatal examination for dysmorphology revealed 6 chromosomal anomalies (4 Down syndrome; 2 Turner syndrome) among the 8 major malformations in the study group, but none in the controls (p < 0.0001). Three of the 39 fetuses with ‘soft markers’ and elevated MShCG were found to have trisomy 21.
Conclusion
Isolated elevation of MShCG does not confer an increased risk of fetal congenital anomalies other than chromosomal abnormalities. However, elevated MShCG levels in combination with sonographic ‘soft markers’ for aneuploidy were associated with a high incidence of chromosomal anomalies, despite a normal biochemical triple screen risk estimate. Copyright © 2005 John Wiley & Sons, Ltd.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Birth control</subject><subject>Chorionic Gonadotropin - blood</subject><subject>Congenital Abnormalities - blood</subject><subject>congenital anomaly risk</subject><subject>elevated serum hCG</subject><subject>Female</subject><subject>Fetal Diseases - blood</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Hormonal contraception</subject><subject>Humans</subject><subject>Mass Screening</subject><subject>Medical sciences</subject><subject>Pregnancy</subject><subject>Pregnancy Trimester, Second</subject><issn>0197-3851</issn><issn>1097-0223</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp10E1v1DAQBmALUdGlIP4B8gU4oBR_ENs5VgtsK1aA-BBHa2JP2tAkXuyEstf-8jraiJ642Nbo0YznJeQZZ6ecMfFm50855-wBWXFW6YIJIR-SFeP5LU3Jj8njlH5laESlH5FjXuqKKyVX5HYL7pqGhroQI3YwtmGgNY43iAPFDv_AiJ72-YwDdDRhnHp6td5QP8V2uMwFFwZfjLHtMWVE6za4K-xbN2sXc5uZweBpg2OuZX6Za_MThtBDt39CjhroEj5d7hPy48P77-vzYvt5c7E-2xZOGskKwSS-rZ1oUBpoZFN5VNo3winHnKx4KUztS-eNV-hLDYI5rVSpmQGQAEaekJeHvrsYfk_5t7Zvk8OugwHDlKzSmgltVIavDtDFkFLExu7yehD3ljM7x2133s5xZ_l8aTnVPfp7t-SbwYsFQMqJNBEG16Z7p5QSvJwbvT64m7bD_f_m2S_vlrHFQbc58r__NMTrvITUpf35aWPl9hv7eq4-WiPvACRhpp0</recordid><startdate>200503</startdate><enddate>200503</enddate><creator>Celentano, Claudio</creator><creator>Guanciali-Franchi, Paolo Emilio</creator><creator>Liberati, Marco</creator><creator>Palka, Chiara</creator><creator>Fantasia, Donatella</creator><creator>Morizio, Elisena</creator><creator>Calabrese, Giuseppe</creator><creator>Stuppia, Liborio</creator><creator>Rotmensch, Siegfried</creator><general>John Wiley & Sons, Ltd</general><general>Wiley</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200503</creationdate><title>Lack of correlation between elevated maternal serum hCG during second-trimester biochemical screening and fetal congenital anomaly</title><author>Celentano, Claudio ; Guanciali-Franchi, Paolo Emilio ; Liberati, Marco ; Palka, Chiara ; Fantasia, Donatella ; Morizio, Elisena ; Calabrese, Giuseppe ; Stuppia, Liborio ; Rotmensch, Siegfried</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3830-203e4bc2fe38af3f9de67df2c6c0c391528bd5cd8d6ed57a20c7665708aa3aa83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Birth control</topic><topic>Chorionic Gonadotropin - blood</topic><topic>Congenital Abnormalities - blood</topic><topic>congenital anomaly risk</topic><topic>elevated serum hCG</topic><topic>Female</topic><topic>Fetal Diseases - blood</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Hormonal contraception</topic><topic>Humans</topic><topic>Mass Screening</topic><topic>Medical sciences</topic><topic>Pregnancy</topic><topic>Pregnancy Trimester, Second</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Celentano, Claudio</creatorcontrib><creatorcontrib>Guanciali-Franchi, Paolo Emilio</creatorcontrib><creatorcontrib>Liberati, Marco</creatorcontrib><creatorcontrib>Palka, Chiara</creatorcontrib><creatorcontrib>Fantasia, Donatella</creatorcontrib><creatorcontrib>Morizio, Elisena</creatorcontrib><creatorcontrib>Calabrese, Giuseppe</creatorcontrib><creatorcontrib>Stuppia, Liborio</creatorcontrib><creatorcontrib>Rotmensch, Siegfried</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Prenatal diagnosis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Celentano, Claudio</au><au>Guanciali-Franchi, Paolo Emilio</au><au>Liberati, Marco</au><au>Palka, Chiara</au><au>Fantasia, Donatella</au><au>Morizio, Elisena</au><au>Calabrese, Giuseppe</au><au>Stuppia, Liborio</au><au>Rotmensch, Siegfried</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Lack of correlation between elevated maternal serum hCG during second-trimester biochemical screening and fetal congenital anomaly</atitle><jtitle>Prenatal diagnosis</jtitle><addtitle>Prenat. Diagn</addtitle><date>2005-03</date><risdate>2005</risdate><volume>25</volume><issue>3</issue><spage>220</spage><epage>224</epage><pages>220-224</pages><issn>0197-3851</issn><eissn>1097-0223</eissn><coden>PRDIDM</coden><abstract>Objective
Isolated elevations in midtrimester maternal serum human chorionic gonadotrophin concentrations (MShCG) have been reported to be associated with a substantially increased likelihood of fetal congenital malformations. The reported malformations included a wide range of organ systems, originating at different embryologic developmental stages. The purpose of our study was to determine the significance of an isolated elevated MShCG (>2.5 MoM) in midtrimester for the detection of fetal structural anomalies in a large population.
Methods
Among 10 144 women who underwent a biochemical triple screen at 15 to 18 weeks' gestation, 463 patients, who had an elevated MShCG, but normal α‐fetoprotein (AFP) and unconjugated estriol (uE3) levels, were identified. Patients with an integrated calculated Down syndrome risk above 1:250 were excluded. Only nonsmokers, at ages <35 years, without a history of prior fetal anomalies were included. The control group consisted of 463 patients with normal serum analyte concentrations and Down syndrome risks below 1:250, who were matched for maternal age and date of biochemical screen. All patients underwent a detailed genetic sonogram in which an anatomic survey and multiple ‘soft markers’ for aneuploidy were looked for. Newborns were examined by a senior pediatrician trained in dysmorphology.
Results
MShCG levels were 3.18 ± 0.72 versus 0.99 ± 0.43 MoM (p < 0.0001) in study and control groups respectively. Sonography revealed 8 versus 6 cases of major congenital anomalies among the 463 patients of their respective groups, and 39 versus 36 sonographic ‘soft markers’ for aneuploidy. Fetal karyotyping and neonatal examination for dysmorphology revealed 6 chromosomal anomalies (4 Down syndrome; 2 Turner syndrome) among the 8 major malformations in the study group, but none in the controls (p < 0.0001). Three of the 39 fetuses with ‘soft markers’ and elevated MShCG were found to have trisomy 21.
Conclusion
Isolated elevation of MShCG does not confer an increased risk of fetal congenital anomalies other than chromosomal abnormalities. However, elevated MShCG levels in combination with sonographic ‘soft markers’ for aneuploidy were associated with a high incidence of chromosomal anomalies, despite a normal biochemical triple screen risk estimate. Copyright © 2005 John Wiley & Sons, Ltd.</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>15791663</pmid><doi>10.1002/pd.1110</doi><tpages>5</tpages></addata></record> |
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| ispartof | Prenatal diagnosis, 2005-03, Vol.25 (3), p.220-224 |
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| source | MEDLINE; Wiley Online Library Journals |
| subjects | Adult Biological and medical sciences Birth control Chorionic Gonadotropin - blood Congenital Abnormalities - blood congenital anomaly risk elevated serum hCG Female Fetal Diseases - blood Gynecology. Andrology. Obstetrics Hormonal contraception Humans Mass Screening Medical sciences Pregnancy Pregnancy Trimester, Second |
| title | Lack of correlation between elevated maternal serum hCG during second-trimester biochemical screening and fetal congenital anomaly |
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