Association of Increased Second Trimester Serum Markers with Adverse Perinatal Outcome

Authors:  Tezcan B, Watson H, Percival S, Ramskill N,  Sau A


Evidence has been inconsistent and at times conflicting with little data focusing on how predictive and effective serum alpha-fetoprotein (AFP) and human chorionic gonadotropin (hCG) as a marker of poor pregnancy outcome. In addition, no definite protocol has been developed on how to approach women found to have high level of serum AFP and hCG. The purpose of this study is to assess the association between the raised serum AFP on its own or combined with raised hCG with the adverse pregnancy outcome. At University Hospital Lewisham, all pregnant women are offered a second trimester  quadruple test if they miss their first trimester screening due to late presentation. 281 women had raised serum AFP of >2 MoM and in 70 cases both serum AFP and beta-hCG  were raised ( >2MoM). The result of this study demonstrates that pregnancy complications were increased in women with unexplained abnormal quadruple screen analytes (high AFP and beta hCG levels of >2MoM). Although caution must be undertaken not to cause unnecessary anxiety, we feel that increased awareness and patient education could prevent certain pregnancy complications. Serum markers, in combination with other modalities such as ultrasound and Doppler, may improve detection rates of abnormal pregnancy outcomes.





Download Full Paper

Association of increased second trimester serum markers with adverse perinatal outcome