Mid-trimester triple test levels in early and late onset severe pre-eclampsia.
OBJECTIVE
To study whether the degree of elevation of mid-trimester triple test markers differs in patients with early versus late onset severe pre-eclampsia.


METHODS
A retrospective study of the medical records of 102 patients with severe pre-eclampsia for whom mid-trimester triple test result data were available was made. None of these patients had fetuses with abnormal karyotype nor delivered infants with malformations. Pre-eclampsia was defined as early onset when it presented before 32 weeks' gestation. The levels of mid-trimester maternal serum alpha-fetoprotein (MSAFP), human chorionic gonadotrophin (hCG) and unconjugated oestriol (MSuE(3)) in patients with early and late onset severe pre-eclampsia were compared.


RESULTS
Twenty-five patients had early onset and 77 patients had late onset severe pre-eclampsia. The two groups did not differ significantly with regard to age, weight, parity and severity of pre-eclampsia. The mean MSAFP in patients with early onset was significantly higher than in patients with late onset severe pre-eclampsia (1.46 MoM, SE 0.12 versus 1.16 MoM, SE 0.05; p=0.01). The mean hCG in the early onset group was also significantly higher than in the late onset group (1.71 MoM, SE 0.18 versus 1.21 MoM, SE 0.07; p=0.03). Mean MSuE(3) levels in patients with early onset were significantly lower than in patients with late onset severe pre-eclampsia (0.83 MoM, SE 0.05 versus 1.02 MoM, SE 0.03; p=0.04).


CONCLUSIONS
Higher MSAFP and hCG, and lower MSuE(3), may be more significant markers of early rather than late onset severe pre-eclampsia.
Department of Obstetrics and Gynecology, Barzilai Medical Center, The Faculty of Health Sciences, Ben-Gurion University of the Negev, Ashkelon, Israel.
Simon
S
Shenhav
Ofer
O
Gemer
Essie
E
Sassoon
Michael
M
Volodarsky
Ronit
R
Peled
Shmuel
S
Segal
D000328:Adult; D015415:Biomarkers; D006063:Chorionic Gonadotropin / Q000097:blood*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D011225:Pre-Eclampsia / Q000097:blood* / Q000503:physiopathology; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011507:Proteinuria / Q000097:blood; D012189:Retrospective Studies; D000509:alpha-Fetoproteins / Q000032:analysis*
D015415:Biomarkers; D006063:Chorionic Gonadotropin; D000509:alpha-Fetoproteins