title: Second-trimester maternal serum markers in twin pregnancy with complete mole: report of 2 cases.
abstract: We present second-trimester serum marker levels in cases of twin pregnancy with complete hydatidiform mole and a coexistent fetus (CHMCF). Second-trimester inhibin A (InhA) levels have not been previously reported in such cases. Second-trimester maternal serum screening, alpha-fetoprotein (AFP), unconjugated estriol (uE3), human chorionic gonadotropin (hCG), and InhA measurements combined with maternal age to estimate a patient's risk of Down syndrome during pregnancy was performed as a routine prenatal test in 2 cases of CHMCF. Hospital records containing serum marker data, patient history, pathology reports, and pregnancy outcome were reviewed. In cases of CHMCF, maternal serum AFP and uE3 levels were similar to those of a normal singleton pregnancy, whereas hCG and InhA levels were markedly increased. Second-trimester maternal serum marker profiles in cases of CHMCF are a composite of normal singleton and molar tissue secretions. We have found, for the first time, that second-trimester InhA levels are markedly increased in these cases. Serum marker levels may be useful in diagnosis of CHMCF, prenatal counseling, and evaluation of risk for persistent trophoblastic disease.
authors.affiliation: Department of Pathology and Laboratory Medicine, Women and Infants' Hospital and Brown University, 70 Elm Street, 2nd floor, Providence, RI 02903, USA. gmesserl@wihri.org
authors.forename: Geralyn
authors.initials: G
authors.lastname: Lambert-Messerlian
authors.forename: Halit
authors.initials: H
authors.lastname: Pinar
authors.forename: Lewis P
authors.initials: LP
authors.lastname: Rubin
authors.forename: Monique E
authors.initials: ME
authors.lastname: De Paepe
authors.forename: Umadevi
authors.initials: U
authors.lastname: Tantravahi
authors.forename: Margaret M
authors.initials: MM
authors.lastname: Steinhoff
authors.forename: Michelle
authors.initials: M
authors.lastname: Russell
authors.forename: Jacob A
authors.initials: JA
authors.lastname: Canick
mesh_terms: D000293:Adolescent; D000328:Adult; D014408:Biomarkers, Tumor / Q000097:blood; D006063:Chorionic Gonadotropin / Q000097:blood*; D005260:Female; D006801:Humans; D006828:Hydatidiform Mole / Q000097:blood* / Q000473:pathology; D007265:Inhibins / Q000097:blood*; D008297:Male; D011247:Pregnancy / Q000097:blood*; D011262:Pregnancy Trimester, Second; D014427:Twins; D014594:Uterine Neoplasms / Q000097:blood* / Q000473:pathology
chemical_list: D014408:Biomarkers, Tumor; D006063:Chorionic Gonadotropin; C422362:inhibin A; D007265:Inhibins