Unexplained Elevated Levels Of Midtrimester Maternal Serum alpha-fetoprotein Are Associated With Spontaneous Preterm Birth / 대한산부인과학회잡지

OBJECTIVES: Our purpose was 1) to determine whether elevated maternal serum alpha- fetoprotein(MSAFP) predict increased risk of spontaneous preterm delivery and indicated preterm delivery; 2) to determine whether elevated maternal serum human chorionic gonadotropin(MSHCG) predict increased risk of preterm delivery. Methods: Between September 1995 and April 1998, 945 of 2105 pregnant women who received midtrimester MSAFP screening were identified and evaluated. 81 women with MSAFP levels of 2.0 MoM or more were included in the study group while 864 women with levels less than 2.0 MoM served as controls. Pregnancy outcome were obtained from hospital records and statistical analysis were performed. RESULTS: Women with elevated MSAFP levels showed an increased risk for preterm delivery(p<0.05), fetal growth restriction(p<0.05) and hypertensive disorders(p<0.05), but not for preterm premature rupture of membrane, fetal death in utero. There was a strong association between unexplained elevated MSAFP levels and spontaneous preterm delivery(p<0.05) but our study does not support an association between unexplained elevated MSAFP levels and indicated preterm delivery. There was no association between elevated MSHCG levels and preterm delivery regardless of MSAFP levels. CONCLUSION: We concluded that unexplained elevated levels of midtrimester MSAFP were associated with an elevated risk of spontaneous preterm delivery but not with a risk of indicated preterm delivery. Elevated MSHCG levels were not associated with a risk of preterm delivery and spontaneous preterm birth.

Pegnancy Outcomes in Women with Unexplained Midtrimester Elevation of Maternal Serum Human Chorionic Gonadotropin Level / 대한산부인과학회잡지

OBJECTIVE: Our purpose was to determine whether unexplained elevation in maternal serum human chorionic gonadotropin without abnormal elevation in matemal serum alpha-fetoprotein (MSAFP) in the second trimester may be associated with adverse pregnancy outcomes. METHODS: Between January 1997 and December 1997, we evaluated 906 pregnant women undergoing second trimester triple marker screening tests who delivered at our hospital. Multiple pregnancy, fetal anomaly, intrauterine fetal death before 20 completed weeks of gestational age, insulin dependent diabetes mellitus and maternal serum alpha-fetoprotein level greater than 2.0 multiple of the median (MoM) were excluded fiom the study. Seventy-two women with hCG level greater than 2.0 MoM were included in the study group while 809 women with hCG level less than 2.0 MoM served as the control group. Adverse pregnancy outcomes were obtained from hospital delivery records and neonatal records. Statistical analysis were performed by students t-test and chi square test. RESULTS: Women with unexplained elevation of human chorionic gonadotropin level showed increased risks for intrauterine growth retardation (P<0.01) and pregnancy induced hypertension (P<0.05). There were no significant differences between study and control groups with respect to preterm delivery, placental abruption, fetal anomaly and intrauterine fetal death. CONCLUSION: Unexplained elevation of human chorionic gonadotropin in the second trimester was associated with intrauterine growth retardation and pregnancy induced hypertension.