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Second trimester amniotic fluid oestriol, dehydroepiandrosterone sulphate, and human chorionic gonadotrophin levels
H S Cuckle1, N J Wald, J W Densem
1Department of Environmental and Preventive Medicine, St Bartholomew's Medical College, London.
Objective:
To investigate the reason for low maternal serum unconjugated oestriol (uE3) and raised human chorionic gonadotrophin (hCG) levels in Down's syndrome pregnancies.
Design:
Measurement of uE3, total oestriol (tE3), dehydroepiandrosterone sulphate (DHEAS), a precursor of oestriol, and hCG in 15-20 week amniotic fluid samples from pregnancies with and without Down's syndrome.
Setting:
The retrieval and use of stored amniotic fluid samples collected from women who had had an amniocentesis for antenatal diagnosis.
Subjects:
45 women with a Down's syndrome pregnancy and 224 unaffected controls of the same gestational age.
Results:
The median level of amniotic fluid in affected pregnancies was low for uE3, tE3 and DHEAS but high for hCG: 0.50, 0.46, 0.35 and 1.58 multiples of the normal median, respectively.
Conclusion:
These results suggest that the abnormal maternal serum levels of uE3 and hCG in affected pregnancies are due mainly to abnormal feto-placental synthesis, rather than feto-maternal transfer.