title: Elevated maternal second-trimester serum alpha-fetoprotein as a risk factor for placental abruption.
abstract: OBJECTIVE
  To analyze the association of second-trimester maternal serum alpha-fetoprotein (MSAFP) and free beta human chorionic gonadotrophin (MSbeta-hCG) levels to placental abruption.
  
  
  METHODS
  Fifty-seven women with placental abruption and 108 control women without placental abruption were tested for second-trimester MSAFP and MSbeta-hCG levels as a part of a trisomy 21 screening program. Discriminatory cutoff levels for MSAFP were sought to predict placental abruption.
  
  
  RESULTS
  The median of the MSAFP multiples of median (MoM) (1.21) was significantly higher in the abruption group than in the control group (1.07) (p = 0.004). In multivariate analysis, elevated MSAFP remained an independent risk factor for placental abruption when adjusting for other risk factors (parity >/= 3, smoking, previous placental abruption, preeclampsia, bleeding in II or III trimester, and placenta previa). MSAFP >/= 1.5 MoM had a sensitivity of 29% and a false-positive rate of 10%. The levels of the MSbeta-hCG MoM did not differ between the cases and the controls.
  
  
  CONCLUSIONS
  Although second-trimester MSAFP levels are higher in women with subsequent placental abruption, the clinical usefulness of this test is limited due to low sensitivity and high false-positive rate.
authors.affiliation: Department of Obstetrics and Gynecology, University Central Hospital, Helsinki, Finland.
authors.forename: Minna
authors.initials: M
authors.lastname: Tikkanen
authors.forename: Esa
authors.initials: E
authors.lastname: Hämäläinen
authors.forename: Mika
authors.initials: M
authors.lastname: Nuutila
authors.forename: Jorma
authors.initials: J
authors.lastname: Paavonen
authors.forename: Olavi
authors.initials: O
authors.lastname: Ylikorkala
authors.forename: Vilho
authors.initials: V
authors.lastname: Hiilesmaa
mesh_terms: D000037:Abruptio Placentae / Q000097:blood / Q000175:diagnosis*; D000328:Adult; D015415:Biomarkers / Q000097:blood; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D005260:Female; D006801:Humans; D016015:Logistic Models; D015999:Multivariate Analysis; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011296:Prenatal Diagnosis / Q000379:methods; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D000509:alpha-Fetoproteins / Q000032:analysis*
chemical_list: D015415:Biomarkers; D018997:Chorionic Gonadotropin, beta Subunit, Human; D000509:alpha-Fetoproteins