open access

Vol 91, No 12 (2020)
Research paper
Published online: 2020-12-31
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The significance of maternal blood pregnancy-associated plasma protein A (PAPP-A) and free beta-subunit of human chorionic gonadotropin (β-hCG) levels for the risk assessment of fetal trisomy 18 during the first prenatal testing between 11 and 13+6 weeks of pregnancy

Katarzyna Ziolkowska1, Kinga Tobola-Wrobel2, Piotr Dydowicz3, Sebastian Zurawski1, Marek Pietryga3, Ewa Wysocka1
DOI: 10.5603/GP.a2020.0126
·
Pubmed: 33447994
·
Ginekol Pol 2020;91(12):748-754.
Affiliations
  1. Chair and Department of Laboratory Diagnostics, Poznan University of Medical Sciences, Poznan, Poland
  2. Department of Obstetrics and Women’s Health, Chair of Gynaecology, Obstetrics and Gynaecological Oncology, Poznan University of Medical Sciences, Poznan, Poland
  3. Prenatal Diagnostic Centre, Gynaecology and Obstetrics Hospital, Poznan University of Medical Sciences, Poznan, Poland

open access

Vol 91, No 12 (2020)
ORIGINAL PAPERS Obstetrics
Published online: 2020-12-31

Abstract

Objective: The aim of the study was to evaluate the significance of the maternal blood level of pregnancy-associated plasma
protein A (PAPP-A) and free beta-subunit of human chorionic gonadotropin (β-hCG), to estimate the risk of fetal trisomy
18 and their correlation with the assessment of nuchal translucency (NT) during the first prenatal testing.
Material and methods: Examinations of 93 pregnant women between 11 and 13+6 weeks of pregnancy were conducted,
which included determination of β-hCG and PAPP-A concentrations in the maternal serum and ultrasound assessment of
fetal nuchal translucency. Concentrations of biochemical parameters were expressed as multiples of median (MoM) for the
appropriate gestational age. The risk assessment of trisomy 18 was analyzed using Astraia software. Pregnant women with
a high (≥ 1:300) risk of trisomy 18 were offered a genetic amniocentesis with an examination of fetal karyotype. Twenty
cases were healthy and 23 with trisomy 18.
Results: PAPP-A and β-hCG MoM values < 0.3 were found in 61% cases of fetal trisomy 18. In 26% of cases, PAPP-A and
β-hCG MoM values < 0.2 were NT-independent risk factors for trisomy 18. There were no significant differences between
groups with normal fetal karyotype (40%) and trisomy 18 (35%) in PAPP-A and β-hCG MoM 0.2–0.5 range.
Conclusions: Maternal free β-hCG MoM was found to change parallelly to fetal NT widening in case of trisomy 18 diagnosis.
Maternal β-hCG and PAPP-A MoM results presented less then 0.2 might be used independently of NT widening in
fetus for trisomy 18 risk evaluation. Above 0.2 for PAPP-A and β-hCG MoMs, fetal NT measurement was an requirment.

Abstract

Objective: The aim of the study was to evaluate the significance of the maternal blood level of pregnancy-associated plasma
protein A (PAPP-A) and free beta-subunit of human chorionic gonadotropin (β-hCG), to estimate the risk of fetal trisomy
18 and their correlation with the assessment of nuchal translucency (NT) during the first prenatal testing.
Material and methods: Examinations of 93 pregnant women between 11 and 13+6 weeks of pregnancy were conducted,
which included determination of β-hCG and PAPP-A concentrations in the maternal serum and ultrasound assessment of
fetal nuchal translucency. Concentrations of biochemical parameters were expressed as multiples of median (MoM) for the
appropriate gestational age. The risk assessment of trisomy 18 was analyzed using Astraia software. Pregnant women with
a high (≥ 1:300) risk of trisomy 18 were offered a genetic amniocentesis with an examination of fetal karyotype. Twenty
cases were healthy and 23 with trisomy 18.
Results: PAPP-A and β-hCG MoM values < 0.3 were found in 61% cases of fetal trisomy 18. In 26% of cases, PAPP-A and
β-hCG MoM values < 0.2 were NT-independent risk factors for trisomy 18. There were no significant differences between
groups with normal fetal karyotype (40%) and trisomy 18 (35%) in PAPP-A and β-hCG MoM 0.2–0.5 range.
Conclusions: Maternal free β-hCG MoM was found to change parallelly to fetal NT widening in case of trisomy 18 diagnosis.
Maternal β-hCG and PAPP-A MoM results presented less then 0.2 might be used independently of NT widening in
fetus for trisomy 18 risk evaluation. Above 0.2 for PAPP-A and β-hCG MoMs, fetal NT measurement was an requirment.

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Keywords

trisomy 18; pregnancy-associated plasma protein A (PAPP-A); free beta-subunit of human chorionic gonadotropin (β-hCG); nuchal translucency

About this article
Title

The significance of maternal blood pregnancy-associated plasma protein A (PAPP-A) and free beta-subunit of human chorionic gonadotropin (β-hCG) levels for the risk assessment of fetal trisomy 18 during the first prenatal testing between 11 and 13+6 weeks of pregnancy

Journal

Ginekologia Polska

Issue

Vol 91, No 12 (2020)

Article type

Research paper

Pages

748-754

Published online

2020-12-31

DOI

10.5603/GP.a2020.0126

Pubmed

33447994

Bibliographic record

Ginekol Pol 2020;91(12):748-754.

Keywords

trisomy 18
pregnancy-associated plasma protein A (PAPP-A)
free beta-subunit of human chorionic gonadotropin (β-hCG)
nuchal translucency

Authors

Katarzyna Ziolkowska
Kinga Tobola-Wrobel
Piotr Dydowicz
Sebastian Zurawski
Marek Pietryga
Ewa Wysocka

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