Elevated mid-trimester hCG and maternal lupus anticoagulant.
An association is described between women with lupus anticoagulant and abnormal prenatal serum screening results. Three cases of positive second-trimester serum screening for Down syndrome, with karyotypically normal fetuses, in women demonstrated to have lupus anticoagulant are presented. Serum screening positivity was principally due to a disproportionately elevated maternal serum human chorionic gonadotrophin (hCG) level. In each case, early, severe intrauterine growth restriction was documented, with only one fetus surviving the neonatal period. As maternal lupus anticoagulant may have a profoundly adverse effect on the course of pregnancy, we suggest that an elevated hCG level on prenatal screening prompt consideration of maternal lupus anticoagulant testing if ultrasonography demonstrates an otherwise normal singleton gestation and the fetal karyotype is normal.
Clark
F
F
Department of Obstetrics, King Edward Memorial Hospital for Women, Subiaco, Australia.
Dickinson
J E
JE
Walters
B N
BN
Marshall
L R
LR
O'Leary
P C
PC
D000328:Adult; D006063:Chorionic Gonadotropin / Q000097:blood*; D004314:Down Syndrome / Q000175:diagnosis*; D005189:False Positive Reactions; D005260:Female; D005317:Fetal Growth Retardation / Q000175:diagnosis; D006801:Humans; D007621:Karyotyping; D016682:Lupus Coagulation Inhibitor / Q000009:adverse effects / Q000097:blood*; D011225:Pre-Eclampsia / Q000150:complications; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011296:Prenatal Diagnosis; D000509:alpha-Fetoproteins / Q000032:analysis
D006063:Chorionic Gonadotropin; D016682:Lupus Coagulation Inhibitor; D000509:alpha-Fetoproteins