Early vaginal bleeding has no impact on markers used in first trimester aneuploidy screening.
OBJECTIVE
To assess the impact of early vaginal bleeding on the levels of markers used in first trimester screening for aneuploidy.


METHODS
A retrospective analysis was carried out on the free beta human chorionic gonadotrophin (beta-hCG) and pregnancy associated plasma protein-A (PAPP-A) levels and nuchal translucency thickness in 49 653 women with a normal singleton fetus who had first trimester combined screening for Down Syndrome in three centres. Median MoMs and the distribution of log MoMs of the two markers were compared in two groups-7470 women who self-reported vaginal bleeding and 42 183 women who reported no vaginal bleeding at any stage prior to the screening test.


RESULTS
The overall median MoM free beta-hCG and that in the bleeding and non-bleeding group were 0.9854, 1.0012 and 0.9832, and for PAPP-A were 1.0407, 1.0413 and 1.037. There was no significant difference between the bleeding and non-bleeding group by median test (p = 0.080) or by t-test comparing log MoMs (p = 0.1305) for free beta-hCG and for PAPP-A with median test (p = 0.5071) or by t-test comparing log MoMs (p = 0.1740). For delta nuchal translucency (NT) there was also no significant difference between the bleeding and non-bleeding group (p = 0.055).


CONCLUSIONS
Vaginal bleeding has little or no impact on first trimester marker levels and no correction is necessary.
Spencer
K
K
Prenatal Screening Unit, Clinical Biochemistry Department, King George Hospital, Goodmayes IG3 8YB, UK. KevinSpencer1@aol.com
Spencer
C E
CE
Stamatopoulou
A
A
Staboulidou
I
I
Nicolaides
K H
KH
D000328:Adult; D000782:Aneuploidy; D015415:Biomarkers / Q000032:analysis* / Q000097:blood; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000032:analysis / Q000097:blood; D005260:Female; D005820:Genetic Testing / Q000379:methods* / Q000592:standards; D006801:Humans; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood* / Q000235:genetics; D011266:Pregnancy-Associated Plasma Protein-A / Q000032:analysis; D011296:Prenatal Diagnosis / Q000379:methods / Q000592:standards; D012189:Retrospective Studies; D013997:Time Factors; D014592:Uterine Hemorrhage / Q000097:blood* / Q000453:epidemiology / Q000235:genetics
D015415:Biomarkers; D018997:Chorionic Gonadotropin, beta Subunit, Human; D011266:Pregnancy-Associated Plasma Protein-A