Correlation of maternal triple screen values with fetal liver length

Objective: To determine if a relationship exists between fetal liver length and any of the three serum markers (AFP, uE3, and hCG) that constitute the maternal triple marker screen.Methods: From March to November of 1996, 124 randomly selected women between 17.0 and 20.3 weeks gestation underwent serum triple screen testing on the same day that an anatomy sonogram was performed by a single sonographer. Fetal liver size was measured between the right hemidiaphragm and the tip of the right hepatic lobe. All triple marker screen results were obtained from the same commercial lab. Utilizing linear regression analysis, liver length adjusted for gestational age was plotted versus AFP, uE3, and hCG measurements (expressed as multiples of the median).Results: Of the 124 subjects, 17 (14%) were white and 97 (78%) were black; the remaining 10 (8%) were unknown or other. Neither hCG nor AFP measurements had a statistically significant association with liver length after taking into account gestational age (linear regression: R = -0.018, P =.848 and R = 0.100, P =.269 for hCG and AFP, respectively). Interestingly, a statistically significant correlation was identified between uE3 levels and fetal liver length (R = 0.205, P =.023).Conclusions: No statistical significance was identified between either maternal serum hCG or AFP and fetal liver size. A statistically significant correlation between maternal serum uE3 and liver size was observed. Although preliminary, sonographic evaluation of fetal liver size has little role in elucidating the etiology of abnormal hCG or AFP levels, but may be relevant in the interpretation of abnormal uE3 values.