open access

Vol 91, No 11 (2020)
Research paper
Published online: 2020-11-30
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Evaluation of indications for amniocentesis in cases of normal fetal ultrasound results

Olaf Wojtowicz1, Sylwia Dzidek1, Hanna Baran1, Jedrzej Wiacek1, Dariusz Borowski2, Aneta Cymbaluk-Ploska1, Bartosz Czuba3, Anna Kajdy4, Andrzej Torbe1, Sebastian Kwiatkowski1
DOI: 10.5603/GP.2020.0117
·
Pubmed: 33301164
·
Ginekol Pol 2020;91(11):693-699.
Affiliations
  1. Department Obstetrics and Gynecology, Pomeranian Medical University in Szczecin, Poland
  2. Clinic of Fetal-Maternal, Gynecology and Neonatolgy, Collegium Medicum, Nicolaus Copernicus University in Bydgoszcz, Poland, Poland
  3. Department of Obstetrics and Gynecology in Ruda Slaska, Medical University of Silesia, Poland, Poland
  4. Medical University of Warsaw, Poland, Poland

open access

Vol 91, No 11 (2020)
ORIGINAL PAPERS Obstetrics
Published online: 2020-11-30

Abstract

Objectives: The objective of this study was to analyze indications for amniocentesis in cases of patients with normal fetal
ultrasound results between 11+0 and 13+6 weeks of gestation.
Material and methods: The results of first-trimester screening tests performed between 2014 and 2018 on 6,863 patients
of the Prenatal Testing Outpatient Clinic at the Clinical Department of Obstetrics and Gynecology, Pomeranian Medical
University, Szczecin, Poland, were analyzed. The inclusion criteria were a singleton pregnancy and normal results of fetal
ultrasound between 11+0- and 13+6-weeks’ gestation. Depending on the calculated risk of fetal trisomy 21, the patients
were divided into three groups (group A = RS > 1:300, group B = RS 1:300 – 1:999, group C = RS ≤ 1:1000). Subsequently,
values such as PAPP-A and fβ-hCG protein levels and maternal age were analyzed for each of the groups.
Results: The patients, 6,310 (91.94%) met the inclusion criteria. A high risk of fetal trisomy 21 was identified for 514 women
(8.15%). Group B had 733 (11.62%) and group C 5,063 (80.23%) patients. In group A, an fβ-hCG level of ≥ 2.000 MoM was
shown for 50.97% of the women. A PAPP-A level ranging from 0.001 to 0.499 MoM was observed for 38.72% of group
A patients. The mean maternal age in groups A, B and C was 36.45, 36.08 and 31.64 years, respectively.
Conclusions: In the first-trimester, patients with normal ultrasound results obtained during prenatal screening tests, the main
cause of an increased risk of trisomy 21 was elevated PAPP-A and fβ-hCG concentrations. According to this paper’s authors,
in these cases extension of diagnosis to include other gestational complications, e.g. preeclampsia, should be considered.

Abstract

Objectives: The objective of this study was to analyze indications for amniocentesis in cases of patients with normal fetal
ultrasound results between 11+0 and 13+6 weeks of gestation.
Material and methods: The results of first-trimester screening tests performed between 2014 and 2018 on 6,863 patients
of the Prenatal Testing Outpatient Clinic at the Clinical Department of Obstetrics and Gynecology, Pomeranian Medical
University, Szczecin, Poland, were analyzed. The inclusion criteria were a singleton pregnancy and normal results of fetal
ultrasound between 11+0- and 13+6-weeks’ gestation. Depending on the calculated risk of fetal trisomy 21, the patients
were divided into three groups (group A = RS > 1:300, group B = RS 1:300 – 1:999, group C = RS ≤ 1:1000). Subsequently,
values such as PAPP-A and fβ-hCG protein levels and maternal age were analyzed for each of the groups.
Results: The patients, 6,310 (91.94%) met the inclusion criteria. A high risk of fetal trisomy 21 was identified for 514 women
(8.15%). Group B had 733 (11.62%) and group C 5,063 (80.23%) patients. In group A, an fβ-hCG level of ≥ 2.000 MoM was
shown for 50.97% of the women. A PAPP-A level ranging from 0.001 to 0.499 MoM was observed for 38.72% of group
A patients. The mean maternal age in groups A, B and C was 36.45, 36.08 and 31.64 years, respectively.
Conclusions: In the first-trimester, patients with normal ultrasound results obtained during prenatal screening tests, the main
cause of an increased risk of trisomy 21 was elevated PAPP-A and fβ-hCG concentrations. According to this paper’s authors,
in these cases extension of diagnosis to include other gestational complications, e.g. preeclampsia, should be considered.

Get Citation

Keywords

amniocentesis; ultrasonography; prenatal; PAPP-A; HCG-beta

About this article
Title

Evaluation of indications for amniocentesis in cases of normal fetal ultrasound results

Journal

Ginekologia Polska

Issue

Vol 91, No 11 (2020)

Article type

Research paper

Pages

693-699

Published online

2020-11-30

DOI

10.5603/GP.2020.0117

Pubmed

33301164

Bibliographic record

Ginekol Pol 2020;91(11):693-699.

Keywords

amniocentesis
ultrasonography
prenatal
PAPP-A
HCG-beta

Authors

Olaf Wojtowicz
Sylwia Dzidek
Hanna Baran
Jedrzej Wiacek
Dariusz Borowski
Aneta Cymbaluk-Ploska
Bartosz Czuba
Anna Kajdy
Andrzej Torbe
Sebastian Kwiatkowski

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