title: The mid-gestation triple test profile among women diagnosed with vasa previa.
abstract: OBJECTIVE
  To assess the mid-trimester triple test biomarkers among women diagnosed with vasa previa (VP).
  
  
  METHODS
  The study included 43 singleton pregnancies diagnosed with vasa previa between the years 1988 and 2011. The mid-gestation screening test for Down syndrome was calculated from the combination of triple serum markers and maternal age, and expressed as a multiple of the gestation specific normal mean (MoM). Reference MoM values were calculated from the local population. The levels of mid-gestation maternal serum alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), and unconjugated estriol (uE3) of patients with VP were compared with control reference group.
  
  
  RESULTS
  The mean hCG and αFP levels of women diagnosed with VP was significantly higher compared to control reference group (1.42 versus 0.99 MoM; p < .002 and 1.24 versus1.01 MoM; p < .001, respectively). In contrast, there was no significant difference in uE3levels between these two groups (0.99 versus 0.98 MoM; p = .71).
  
  
  CONCLUSIONS
  Our findings suggest that increased mid-gestation hCG and AFP were found among pregnancies complicated with VP. Clinicians should consider targeted scanning of pregnant women with risk factors for VP, including unexplained high maternal levels of hCG and αFP of the triple test, while conducting mid-gestation anomaly scan.
authors.affiliation: a Department of Obstetrics and Gynecology , Assaf Harofeh Medical Center , Zerifin , Israel.|b Sackler School of Medicine , Tel-Aviv University , Tel-Aviv , Israel.
authors.forename: Yaakov
authors.initials: Y
authors.lastname: Melcer
authors.affiliation: a Department of Obstetrics and Gynecology , Assaf Harofeh Medical Center , Zerifin , Israel.|b Sackler School of Medicine , Tel-Aviv University , Tel-Aviv , Israel.
authors.forename: Ron
authors.initials: R
authors.lastname: Maymon
authors.affiliation: a Department of Obstetrics and Gynecology , Assaf Harofeh Medical Center , Zerifin , Israel.|b Sackler School of Medicine , Tel-Aviv University , Tel-Aviv , Israel.
authors.forename: Marina
authors.initials: M
authors.lastname: Pekar-Zlotin
authors.affiliation: a Department of Obstetrics and Gynecology , Assaf Harofeh Medical Center , Zerifin , Israel.|b Sackler School of Medicine , Tel-Aviv University , Tel-Aviv , Israel.
authors.forename: Josef
authors.initials: J
authors.lastname: Tovbin
authors.affiliation: a Department of Obstetrics and Gynecology , Assaf Harofeh Medical Center , Zerifin , Israel.|b Sackler School of Medicine , Tel-Aviv University , Tel-Aviv , Israel.
authors.forename: Noam
authors.initials: N
authors.lastname: Smorgick
authors.affiliation: c Department of Obstetrics and Gynecology , Columbia University Medical Center , New York , NY , USA.
authors.forename: Howard
authors.initials: H
authors.lastname: Cuckle
authors.affiliation: b Sackler School of Medicine , Tel-Aviv University , Tel-Aviv , Israel.|d Department of Obstetrics and Gynecology , Meir Medical Center , Kfar Saba , Israel.
authors.forename: Reuven
authors.initials: R
authors.lastname: Sharony
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D062145:Maternal Serum Screening Tests; D011247:Pregnancy; D012189:Retrospective Studies; D055949:Vasa Previa / Q000097:blood*
keywords: AFP; hCG; mid-gestation triple test serum markers; prenatal; ultrasound; vasa previa