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Detection of hydatidiform mole in maternal serum screening programmes for Down's syndrome
H S Cuckle1, J W Densem, N J Wald
1Department of Environmental and Preventive Medicine, Wolfson Institute of Preventive Medicine, St Bartholomew's Hospital Medical College, London, UK.
Objective:
To determine how frequently hydatidiform mole will be detected in a maternal serum Down's syndrome screening programme.
Design:
Affected pregnancies were identified using a national register. Unconjugated oestriol (uE3) and human chorionic gonadotrophin (hCG) were measured in stored serum samples and alphafetoprotein (AFP) levels were available from previous neural tube defect screening at 15-20 weeks gestation.
Subjects:
Ten pregnancies with a complete mole (i.e., hydropic placenta without a fetus), nine with stored serum samples and one with an AFP level only.
Results:
The median values were 0.08, 0.13 and 1.83 multiples of the normal median for AFP, uE3 and hCG respectively. Six out of nine (67%) tested for all three markers had a high risk of Down's syndrome given maternal age and the marker levels.
Conclusion:
Many molar pregnancies that have not presented clinically before 15 weeks will be detected through Down's syndrome screening.