title: [Interpretation of atypical values of maternal serum markers].
abstract: OBJECTIVE
  Prenatal screening was set up to identify patients at high-risk of chromosome 21 trisomy based on maternal serum markers measurement. However, the risk of trisomy 21 should not be the only result considered by obstetricians. In fact, abnormal marker values can be associated with other fetal diseases and used to improve maternal and fetal follow-up. Our objective was therefore to study other predictive values of maternal serum markers.
  
  
  METHODS
  A search through publications was conducted using the PubMed® or Cochrane® databases.
  
  
  RESULTS
  In case of high PAPP-A there is no link with any complications. Second trimester high hCG or first trimester low hCG are associated with an increased vascular risk. High α-fetoprotein level is a marker of neural tube defects or abdominal wall defect. Persistence of high α-fetoprotein with normal echography can suggest other rare fetal diseases. Low maternal serum markers suggests 18 trisomy. Oestriol reflects the fetal hypothalamo-hypophyseal axis and can be used as a diagnosis tool.
  
  
  CONCLUSIONS
  Serum markers could be interesting tools for the identification of high-risk pregnancy and the prevention of neonatal complications. They also appear as a potential help to diagnose certain congenital malformations.
authors.affiliation: Clinique d'obstétrique, pôle femme-mère nouveau-né, hôpital Jeanne-de-Flandre, CHRU de Lille, 2, avenue Oscar-Lambret, 59037 Lille cedex, France. Electronic address: caroline.geyl@yahoo.fr.
authors.forename: C
authors.initials: C
authors.lastname: Geyl
authors.affiliation: Clinique d'obstétrique, pôle femme-mère nouveau-né, hôpital Jeanne-de-Flandre, CHRU de Lille, 2, avenue Oscar-Lambret, 59037 Lille cedex, France; Université Lille-Nord-de-France, 1, bis rue Georges-Lefebvre, 59044 Lille cedex, France.
authors.forename: D
authors.initials: D
authors.lastname: Subtil
authors.affiliation: Clinique d'obstétrique, pôle femme-mère nouveau-né, hôpital Jeanne-de-Flandre, CHRU de Lille, 2, avenue Oscar-Lambret, 59037 Lille cedex, France.
authors.forename: P
authors.initials: P
authors.lastname: Vaast
authors.affiliation: Clinique d'obstétrique, pôle femme-mère nouveau-né, hôpital Jeanne-de-Flandre, CHRU de Lille, 2, avenue Oscar-Lambret, 59037 Lille cedex, France.
authors.forename: C
authors.initials: C
authors.lastname: Coulon
authors.affiliation: Clinique d'obstétrique, pôle femme-mère nouveau-né, hôpital Jeanne-de-Flandre, CHRU de Lille, 2, avenue Oscar-Lambret, 59037 Lille cedex, France.
authors.forename: E
authors.initials: E
authors.lastname: Clouqueur
authors.affiliation: Clinique d'obstétrique, pôle femme-mère nouveau-né, hôpital Jeanne-de-Flandre, CHRU de Lille, 2, avenue Oscar-Lambret, 59037 Lille cedex, France; Université Lille-Nord-de-France, 1, bis rue Georges-Lefebvre, 59044 Lille cedex, France.
authors.forename: P
authors.initials: P
authors.lastname: Deruelle
authors.affiliation: Clinique d'obstétrique, pôle femme-mère nouveau-né, hôpital Jeanne-de-Flandre, CHRU de Lille, 2, avenue Oscar-Lambret, 59037 Lille cedex, France; Université Lille-Nord-de-France, 1, bis rue Georges-Lefebvre, 59044 Lille cedex, France.
authors.forename: V
authors.initials: V
authors.lastname: Debarge
mesh_terms: D015415:Biomarkers / Q000097:blood*; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D004314:Down Syndrome / Q000097:blood / Q000175:diagnosis*; D004964:Estriol / Q000097:blood; D005260:Female; D006801:Humans; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood; D011266:Pregnancy-Associated Plasma Protein-A / Q000032:analysis; D011296:Prenatal Diagnosis / Q000592:standards*; D012016:Reference Values; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D015415:Biomarkers; D018997:Chorionic Gonadotropin, beta Subunit, Human; D000509:alpha-Fetoproteins; D011266:Pregnancy-Associated Plasma Protein-A; D004964:Estriol
keywords: Marqueurs sériques; PAPP-A; Predictive value; Serum marker; Valeur prédictive; hCG