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Obstetrics & Gynecology 2006;108:651-655
© 2006 by The American College of Obstetricians and Gynecologists
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ORIGINAL RESEARCH

Human Chorionic Gonadotropin and Plasma Protein-A in Alpha0-Thalassemia Pregnancies

Charas Yeu Theng Ong, MRCOG, Chin Peng Lee, FRCOG, Kwok Yin Leung, FRCOG, Elizabeth Lau, PhD and Mary Hoi Yin Tang, FRCOG

From the Department of Obstetrics and Gynecology, the University of Hong Kong.

OBJECTIVE: Maternal serum free ß-human chorionic gonadotropin (ß-hCG) and pregnancy-associated plasma protein-A (PAPP-A) have been used effectively in the screening of Down syndrome in the first trimester. In this study, we aim to measure the value of first-trimester maternal serum free ß-hCG and PAPP-A as predictors of homozygous {alpha}0-thalassemia–affected pregnancies.

METHODS: Free ß-hCG and PAPP-A concentrations were measured in stored maternal serum samples obtained at 12 weeks of gestation from 22 women with fetuses affected by homozygous {alpha}0-thalassemia and from 436 controls matched for maternal age, ethnicity, and weight, as well as gestation at blood sampling.

RESULTS: Maternal serum concentration of free ß-hCG was significantly increased in women with pregnancies affected by homozygous {alpha}0-thalassemia than in controls (P=.001). Concentrations of PAPP-A did not differ between the cases affected by homozygous {alpha}0-thalassemia and the controls (P=.652).

CONCLUSION: Pregnancies affected by homozygous {alpha}0-thalassemia are associated with increased maternal serum free ß-hCG at 11–14 weeks of gestation. This serum analyte alone may not be clinically useful as a predictor of pregnancies affected by homozygous {alpha}0-thalassemia. However, the absence of ultrasound features of fetal anemia and hydropic changes, together with normal maternal serum free ß-hCG and PAPP-A in the first trimester, will be reassuring signs of normality for fetuses at risk of homozygous {alpha}0-thalassemia and, hence, enable women to avoid invasive tests in unaffected pregnancies.

LEVEL OF EVIDENCE: II-2






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Copyright © 2006 by the American College of Obstetricians and Gynecologists.