title: Second trimester serum alpha-fetoprotein level is a significant positive predictor for intrauterine growth restriction in pregnant women with hyperemesis gravidarum.
abstract: OBJECTIVE
  The aim of this study was to determine the association between three parameters of second trimester serum secreening and preterm labor and intrauterine growth restriction (IUGR) in patients with hyperemesis gravidarum (HG).
  
  
  METHODS
  A prospective study on 429 pregnancies with HG was designed to determine the association between alpha-fetoprotein (AFP), unconjugated estriol (uE3), human chorionic gonadotropin (HCG) and pregnancy prognosis in terms of preterm labor, IUGR and birth weight.
  
  
  RESULTS
  In our study group the mean age of patients was 25.4±3.8 years. Mean birth weight was 3180±555 g. Mean AFP, uE3, hCG levels in the study group were 1.44±0.65 MoM, 0.91±0.38 MoM, 1.09±0.64 MoM, respectively. Twenty nine (6.8%) patients delivered before 37 weeks of gestation and 52 (12.1%) patients developed IUGR. Mean MoM values of AFP among patients with preterm labor, IUGR and normal delivery were 1.35±0.45, 1.97±0.81, 1.34±0.58 MoM, respectively (p<0.001). Mean MoM values of hCG among patients with preterm labor, IUGR and normal delivery were 1.46±0.90, 1.35±0.89, 1±0.5 MoM respectively (p<0.001). Mean MoM values of uE3 among patients with preterm labor, IUGR and normal delivery were 0.75±0.25, 0.80±0.30, 0.95±0.40 MoM, respectively (p=0.003). Odds ratio of AFP>1.55 was 3.73 (95% CI, 1.99-6.98, p<0.001) for IUGR after adjustment for HCG.
  
  
  CONCLUSIONS
  Our study suggests that AFP levels of the second trimester screening test higher than 1.55 MoM is significantly associated with IUGR in hyperemesis gravidarum. The second trimester screening test can predict poor outcome in HG.
authors.affiliation: Department of Obstetrics and Gynecology, Dr. Sami Ulus Maternity and Women's Health Teaching and Research Hospital, Ankara, Turkey.
authors.forename: Enis
authors.initials: E
authors.lastname: Ozkaya
authors.affiliation: Department of Endocrinology and Metabolism, Dışkapı Yıldırım Beyazıd Teaching and Research Hospital, Ankara, Turkey.
authors.forename: Evrim
authors.initials: E
authors.lastname: Cakır
authors.affiliation: Department of Obstetrics and Gynecology, Etlik Zübeyde Hanım Maternity and Women's Health Teaching and Research Hospital, Ankara, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Cınar
authors.affiliation: Department of Obstetrics and Gynecology, Etlik Zübeyde Hanım Maternity and Women's Health Teaching and Research Hospital, Ankara, Turkey.
authors.forename: Metin
authors.initials: M
authors.lastname: Altay
authors.affiliation: Department of Obstetrics and Gynecology, Etlik Zübeyde Hanım Maternity and Women's Health Teaching and Research Hospital, Ankara, Turkey.
authors.forename: Orhan
authors.initials: O
authors.lastname: Gelişen
authors.affiliation: Department of Obstetrics and Gynecology, Dr. Sami Ulus Maternity and Women's Health Teaching and Research Hospital, Ankara, Turkey.
authors.forename: Fadıl
authors.initials: F
authors.lastname: Kara
keywords: Second trimester screening; alpha-fetoprotein; hyperemesis gravidarum; intrauterine growth restriction; preterm labor