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Mid-trimester triple test levels in early and late onset severe pre-eclampsia
Simon Shenhav1, Ofer Gemer, Essie Sassoon
1Department of Obstetrics and Gynecology, Barzilai Medical Center, The Faculty of Health Sciences, Ben-Gurion University of the Negev, Ashkelon, Israel.
Objective:
To study whether the degree of elevation of mid-trimester triple test markers differs in patients with early versus late onset severe pre-eclampsia.
Methods:
A retrospective study of the medical records of 102 patients with severe pre-eclampsia for whom mid-trimester triple test result data were available was made. None of these patients had fetuses with abnormal karyotype nor delivered infants with malformations. Pre-eclampsia was defined as early onset when it presented before 32 weeks' gestation. The levels of mid-trimester maternal serum alpha-fetoprotein (MSAFP), human chorionic gonadotrophin (hCG) and unconjugated oestriol (MSuE(3)) in patients with early and late onset severe pre-eclampsia were compared.
Results:
Twenty-five patients had early onset and 77 patients had late onset severe pre-eclampsia. The two groups did not differ significantly with regard to age, weight, parity and severity of pre-eclampsia. The mean MSAFP in patients with early onset was significantly higher than in patients with late onset severe pre-eclampsia (1.46 MoM, SE 0.12 versus 1.16 MoM, SE 0.05; p=0.01). The mean hCG in the early onset group was also significantly higher than in the late onset group (1.71 MoM, SE 0.18 versus 1.21 MoM, SE 0.07; p=0.03). Mean MSuE(3) levels in patients with early onset were significantly lower than in patients with late onset severe pre-eclampsia (0.83 MoM, SE 0.05 versus 1.02 MoM, SE 0.03; p=0.04).
Conclusions:
Higher MSAFP and hCG, and lower MSuE(3), may be more significant markers of early rather than late onset severe pre-eclampsia.