title: Cell-free fetal DNA levels in maternal plasma after elective first-trimester termination of pregnancy.
abstract: OBJECTIVE
  To determine if first-trimester elective termination of pregnancy affects cell-free fetal DNA (fDNA) levels in maternal plasma.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Clinical and academic research centers.
  
  
  METHODS
  One hundred thirty-four women who underwent first-trimester elective termination procedures.
  
  
  METHODS
  None.
  
  
  METHODS
  Real-time polymerase chain reaction (PCR) amplification and measurement of DYS1, a Y-chromosome sequence, was used as a marker of fDNA.
  
  
  RESULTS
  We detected fDNA in pretermination samples from 27 out of 71 patients in the surgical arm, and 29 out of 63 patients in the medical arm. Based on confirmation of male gender in placental tissue, the sensitivity of fDNA detection is 92.6%. We detected fDNA as early as 32 days of gestation, which increased 4.2 genome equivalents/mL/week. In the surgical arm, the mean level of posttermination fDNA, adjusted for the clearance of fDNA in maternal blood, was higher than projected based on an expected increase with gestational age. In the medical arm, six patients had increased fDNA levels up to 11 days following termination.
  
  
  CONCLUSIONS
  We found that fDNA can be reliably quantified in the early first trimester; fDNA elevation that occurs shortly after surgical termination may reflect fetomaternal hemorrhage or destruction of trophoblastic villi. Continued elevation of fDNA for several days may occur following medical termination.
authors.affiliation: Department of Pediatrics, Tufts-New England Medical Center, Boston, Massachusetts 02111, USA.
authors.forename: Tuangsit
authors.initials: T
authors.lastname: Wataganara
authors.forename: Angela Y
authors.initials: AY
authors.lastname: Chen
authors.forename: Erik S
authors.initials: ES
authors.lastname: LeShane
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Sullivan
authors.forename: Lynn
authors.initials: L
authors.lastname: Borgatta
authors.forename: Diana W
authors.initials: DW
authors.lastname: Bianchi
authors.forename: Kirby L
authors.initials: KL
authors.lastname: Johnson
mesh_terms: D000028:Abortion, Induced / Q000009:adverse effects; D041322:Chromosomes, Human, Y / Q000235:genetics; D015331:Cohort Studies; D003199:Computer Systems; D004247:DNA / Q000097:blood* / Q000235:genetics; D005240:Feasibility Studies; D005260:Female; D005331:Fetomaternal Transfusion / Q000175:diagnosis / Q000209:etiology; D005333:Fetus / Q000502:physiology*; D006801:Humans; D008297:Male; D016133:Polymerase Chain Reaction; D011247:Pregnancy / Q000097:blood*; D011261:Pregnancy Trimester, First; D011446:Prospective Studies
chemical_list: D004247:DNA