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Elevated maternal second-trimester serum alpha-fetoprotein as a risk factor for placental abruption
Minna Tikkanen1, Esa Hämäläinen, Mika Nuutila
1Department of Obstetrics and Gynecology, University Central Hospital, Helsinki, Finland.
Prenatal Diagnosis
|January 24, 2007
Summary
Second-trimester maternal serum alpha-fetoprotein (MSAFP) levels are higher in women who experience placental abruption. However, MSAFP is not a clinically useful predictor due to low sensitivity and high false-positive rates.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Biochemical Screening
Background:
- Placental abruption is a significant obstetric complication.
- Early detection of placental abruption is crucial for improved maternal and fetal outcomes.
- Second-trimester biochemical markers are used for various pregnancy screenings.
Purpose of the Study:
- To investigate the association between second-trimester maternal serum alpha-fetoprotein (MSAFP) and free beta human chorionic gonadotrophin (MSbeta-hCG) levels and placental abruption.
- To determine if MSAFP or MSbeta-hCG can serve as predictive markers for placental abruption.
Main Methods:
- A case-control study involving 57 women with placental abruption and 108 controls.
- Measurement of second-trimester MSAFP and MSbeta-hCG levels as part of routine trisomy 21 screening.
- Analysis of MSAFP multiples of median (MoM) to identify discriminatory cutoff levels.
Main Results:
- Median MSAFP MoM was significantly higher in the placental abruption group (1.21) compared to the control group (1.07) (p=0.004).
- Elevated MSAFP remained an independent risk factor for placental abruption after adjusting for other known risk factors.
- An MSAFP cutoff of 1.5 MoM demonstrated 29% sensitivity and a 10% false-positive rate.
- No significant difference in MSbeta-hCG MoM levels was observed between the groups.
Conclusions:
- Second-trimester MSAFP levels are elevated in women who subsequently develop placental abruption.
- The clinical utility of MSAFP for predicting placental abruption is limited by its low sensitivity and high false-positive rate.
- MSbeta-hCG levels do not appear to be associated with placental abruption.
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