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KMID : 0378019970400060061
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New Medical Journal
1997 Volume.40 No. 6 p.61 ~ p.69
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Prenatal Screening Test with Maternal Serum Alpha-fetoprotein, Human Chorionic Gonadotropin, and Unconjugated Estriol
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Abstract
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Maternal serum alpha-fetoprotein(MSAFP), human chorionic gonadotropin(hCG) and unconjugated estriol(uE3)(triple test) can be used to screen. for chromosomally abnormal fetus with fetal Down syndrome. MSAFP being measured in the serum of a pregnant women has been used to diagnose the neural tube defect for a fetus. We used amniocente-sis to make sure chromosomally abnormal fetus with fetal Down syndrome and neural tube defect if they turn out be positive.
The purpose of this study was to investigate the efficacy of a screening protocol using AFP, hCG and uE3 for the antenatal detection of chromosomally abnormal fetus with fetal Down syndrome and neural tube defect for a fetus.
Therefore, the author found the following results by calculating the medians of maternal
serum AFP, hCG and uE3 according to the number of pregnancy weeks, from the serum of
412 pregnant women who took triple test in the department of Obstetrics and Gynecology
of Chungnam National University Hospital from March 1, 1996 to May 30, 1997.
1. The medians of AFP by the number of pregnancy weeks were 28.35 ng/ml for 15 weeks, 32.83 ng/ml for 16 weeks, 38.03 ng/ml for 17 weeks, 44.05 ng/ml for 18 weeks, 51.01 ng/ml for 19 weeks, 59.09 ng/ml for 20 weeks, 68.43 ng/ml for 21 weeks and 79.26 ng/ml for 22 weeks.
2. The medians of hCG by the number of pregnancy weeks were 51.80 IU/ml for 15 weeks, 40.07 IU/ml for 16 weeks, 33.12 IU/ml for 17 weeks, 29.02 IU/ml for 18 weeks, 26.59 IU/ml for 19 weeks, 25.15 IU/ml for 20 weeks, 24.30 IU/ml for 21 weeks and 23.80 IU/ml for 22 weeks.
3. The median of uE; by the number of pregnancy weeks were 2.65 nmol/l for 15 weeks, 3.24 nmol/1 for 16 weeks, 3.95 nmol/1 for 17 weeks, 4.82 nmol/ml for 18 weeks, 5.90 nmol/l for 19 weeks, 7.19 nmol/l for 20 weeks, 8.78 nmol/) for 21 weeks and 10.73 nmol/1 for 22 weeks.
4. From of chromosomally abnormal fetus with fetal Down syndrome screening pro-gram, 54+10.9%) was resulted in positive and 3 cases(8.8%) out of them was turned out to be Down syndrome, trisomy 18 and translocation from the amniocentesis(34c4). When the risk for neural tube defect was set above 2.5 MoM of MSAFP, 38c1(9.2%) was resulted in positive, and one case(3.2%) out of them was turned to be open spin bifida from the amniocentesis (31 aq).
From the above results, the median values of maternal serum AFP, hCG and uE3, being used for the basis of the program of the screening chromosomally abnormal fetus with the fetal Down syndrome and neural tube defect from the pregnant women was established.
From the basis, it is desired to develop the program adapting to our environment and reduce the false rate of the pregnant women who have chromosomally abnormal fetus with fetal Down androme and neural tube defect, and unnecessary amniocentesis.
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KEYWORD
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