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Screening for detecting twin pregnancy

M Mägiste, H Von Schenck, N O Sjöberg

    American Journal of Obstetrics and Gynecology
    |November 15, 1976
    PubMed
    Summary
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    Human placental lactogen (HPL) levels between weeks 29-30 can help detect twin pregnancies. Most women have HPL levels below 5.0 mug/mL, ruling out twins, while higher levels warrant further investigation.

    Area of Science:

    • Obstetrics and Gynecology
    • Maternal-Fetal Medicine
    • Reproductive Endocrinology

    Background:

    • Multiple gestations, such as twin pregnancies, present unique maternal and fetal risks.
    • Accurate early detection of twin pregnancies is crucial for appropriate management and improved outcomes.
    • Human placental lactogen (HPL) is a hormone produced by the placenta with potential diagnostic value.

    Purpose of the Study:

    • To evaluate the utility of human placental lactogen (HPL) measurement for the detection of twin pregnancies.
    • To establish reference ranges for HPL levels during the late second trimester of pregnancy.

    Main Methods:

    • Maternal serum HPL levels were measured between the 29th and 30th weeks of gestation.
    • Statistical analysis was performed to determine the sensitivity and specificity of HPL levels in detecting twin pregnancies.

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  • Ultrasound and X-ray imaging were used as confirmatory diagnostic tools.

    • Main Results:

    • A serum HPL level below 5.0 mug/mL effectively excluded the suspicion of twin pregnancy in 90% of cases.
    • Elevated HPL levels were observed in pregnancies with twins.
    • Higher HPL values required further diagnostic confirmation via imaging.

    Conclusions:

    • Serum HPL estimation is a simple, safe, and effective screening method for twin pregnancies in the late second trimester.
    • Normal HPL levels can reliably rule out twin gestation, reducing the need for further costly imaging.
    • Abnormal HPL levels necessitate confirmatory diagnostic imaging such as ultrasound or X-ray.