Cell-free fetal DNA levels in maternal plasma after elective first-trimester termination of pregnancy.
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.
Wataganara
Tuangsit
T
Department of Pediatrics, Tufts-New England Medical Center, Boston, Massachusetts 02111, USA.
Chen
Angela Y
AY
LeShane
Erik S
ES
Sullivan
Lisa M
LM
Borgatta
Lynn
L
Bianchi
Diana W
DW
Johnson
Kirby L
KL
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
D004247:DNA