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1
Papp-a <1st percentile ( or 54 , 95% ci 28-103 ) and papp-a <5th percentile ( or 27 , 95% ci 19-39 ) and free beta-hcg <1st percentile ( or 27 , 95% ci 13-59 ) were associated with increased risk of intrauterine growth restriction ( iugr ) with positive predictive values of 24.1% , 14.1% , and 14.3% , respectively .
2
Papp-a and free beta-hcg concentrations and nuchal translucency measurements .
3
Papp-a and beta-hcg concentrations measured by the dual assay in 39 first-trimester serum samples correlated excellently with those obtained by delfia single-label papp-a ( r = 0997 ) and the beta-hcg part ( r = 0993 ) of the delfia afp/beta hcg dual-label assay .
4
Serum papp-a and free beta-hcg are first-trimester screening markers for down syndrome .
5
For papp-a , there was no significant change in median across the gestational period of 11 to 20 weeks , whilst for free beta-hcg , there was a significant increase with gestation ( r = 0458 , p < 0001 ) .
6
Median papp-a and beta-hcg levels tended to increase , but not significantly in women who had had 2 or more miscarriages .
7
In papp-a the reverse effect was seen but it did not reach statistical significance ( p = 015 ) and there was no effect for free beta-hcg .
8
Maternal serum papp-a levels in the late first trimester of pregnancy are associated with subsequent fetal growth ( including both physiologic variation and abnormal growth ) , and decreased free beta-hcg is more predictive of hypertensive disorders of pregnancy .
9
Maternal serum papp-a and free beta-hcg were analyzed by fluoroimmunoassay , nuchal translucency ( nt ) was measured by transvaginal sonography .
10
For both papp-a and free beta-hcg , the relationships were linear with slopes of 1.08 and 1.07 .
11
The median papp-a level in smokers was 0.81 mom , a significant reduction ( p < 0005 ) ; free beta-hcg was also reduced ( median 089 mom ) but not significantly ( p = 017 ) , and afp was unaltered .
12
The markers papp-a , free beta-hcg and the nuchal translucency ( nt ) thickness were examined at 12-14 weeks' gestation .
13
Maternal serum papp-a and free beta-hcg were compared between patients with ( n = 64 ) and without habitual abortions ( n = 849 ) .
14
Beta-hcg and papp-a were analyzed in 6441 cases .
15
Maternal serum papp-a and free beta-hcg at 11-13 ( +6 ) weeks and uterine artery pi at 22-24 weeks were measured in 4390 women with singleton pregnancies .
16
The combination of papp-a mom and beta-hcg mom yielded a detection rate ( dr ) for sga of 26% for a 5% false-positive rate ( fpr ) .
17
Mean values of papp-a and beta-hcg were reduced in women who smoked 5 or more cigarettes a day compared with nonsmokers .
18
Normal values of papp-a , free beta-hcg , and nuchal translucency are associated with a very low risk of pregnancy loss at less than 20 weeks .
19
Free beta-hcg and papp-a were measured on dried blood spots and converted to moms .
20
Free beta-hcg , papp-a and fetal nt were measured at 11-14 weeks of gestation in a group of women presenting for first-trimester screening in two oscar centres .
21
0.17 mom for papp-a ; 0.18 mom for free beta-hcg ; and 2.64 mom for nt .
22
Low beta-hcg and papp-a values ( below 04 mom ) were observed in 0.5% of the women including all cases of triploidy and trisomy 18 and 13 .
23
The concentrations of papp-a and free beta-hcg were measured between 10 and 14 weeks and were converted to multiples of medians ( mom ) for comparisons .
24
Free beta-hcg and papp-a levels did not significantly change with the number of notches .
25
Free beta-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 alpha0-thalassemia and from 436 controls matched for maternal age , ethnicity , and weight , as well as gestation at blood sampling .
26
Free beta-hcg , papp-a and nt levels were compared between the ivf and control groups and between the icsi and control groups using the mann-whitney u test .
27
The maternal serum papp-a , free beta-hcg , activin a and inhibin a concentrations at 22 + 0 to 24 + 6 weeks' gestation were measured in samples obtained from women with singleton pregnancies who participated in a screening study for pre-eclampsia by transvaginal color flow doppler measurement of the uterine artery pulsatility index ( pi ) .
28
Differences in median papp-a , free beta-hcg and , to a lesser extent , in nt exist in afro-caribbean , south asian and oriental women .
29
In combination with papp-a , total hcg would identify 52% of cases , somewhat less than the 67% observed with free beta-hcg and papp-a .
30
Combining free beta-hcg and papp-a or all three markers with maternal age would have the ability to detect 74 per cent of cases at a 0.5 per cent false positive rate ( or 64 per cent at a 01 per cent false positive rate ) .
31
Maternal serum-free beta-hcg and papp-a were measured between 11 + 0 and 13 + 6 weeks as part of a routine first-trimester screening program in conjunction with fetal nuchal translucency ( nt ) performed at two sites .
32
Median mom values of papp-a ( 064 versus 102 , p < 0001 ) , beta-hcg ( 074 versus 104 , p = 0007 ) and adam12 ( 074 versus 097 , p = 0004 ) were significantly reduced in cases compared to controls .
33
Correlation with previously established papp-a and free beta-hcg multiple of the medians ( moms ) and delta nuchal translucency ( nt ) were determined and used to model the performance of first-trimester screening with adam 12 in combination with other first-trimester markers at various time periods across the first trimester .
34
Twin pregnancies secrete more papp-a than expected on the basis of singleton controls whereas free beta-hcg production is not increased .
35
First trimester maternal serum papp-a , beta-hcg and adam12 in prediction of small-for-gestational-age fetuses .
36
Adam12 was correlated with papp-a ( r = 01918 ) in the first trimester of cases with trisomy 18 but less so with nt ( r = 01594 ) and free beta-hcg ( r = 00938 ) .
37
A positive correlation between papp-a and crl levels , as well as a weak negative correlation between free beta-hcg and crl , were demonstrated .
38
Both free beta-hcg and papp-a median values demonstrated an exponential relationship with gestational age in days .
39
The median concentrations of papp-a and free beta-hcg , expressed in moms , in the 73 sga pregnancies were 0.83 and 0.95 , respectively , compared with 0.98 and 1.01 , respectively , in the 292 matched controls ( p = 008 and 019 , respectively ) .
40
Stored blood samples from papp-a and beta-hcg testing obtained at gestational age ( ga ) of 8 weeks to 13 weeks and 6 days were analyzed for adam12 .
41
Maternal serum levels of papp-a and free beta-hcg were assayed in stored sera from 32 down's syndrome and 200 unaffected pregnancies .
42
Maternal serum levels of papp-a and free beta-hcg were assayed retrospectively in stored sera from 323 singleton pregnancies at 8-13 weeks' gestation .
43
Likewise , agreement for papp-a and free beta-hcg was excellent for the autodelfia vs .
44
55.3 per cent for papp-a and free beta-hcg ; 68.4 per cent for nt alone ; and 84.6 per cent for papp-a , free beta-hcg and nt .
45
Though spontaneous reduction was not associated with different levels of either analyte , reduction within 4 weeks was associated with higher levels of both papp-a ( 179 versus 118 ; p = 002 ) and free beta-hcg ( 128 versus 096 ; p = 03 ) compared with other pregnancies .
46
The odds of a fetal aneuploidy when the nt was greater than 2.0 multiples of median ( mom ) was 90 , when serum papp-a concentration was less than 0.45 mom , it was 8.6 , and when serum free beta-hcg concentration was greater than 2.2 mom , it was 4.7 .
47
Fluorimetric immunoassays for maternal serum pregnancy-associated plasma protein a ( papp-a ) and free beta-hcg .
48
Low free beta-hcg , low papp-a , and increased nuchal translucency were all associated with an increased rate of fetal abnormality .
49
First-trimester nuchal translucency and maternal serum free beta-hcg and papp-a can detect triploidy and determine the parental origin .
50
The distribution of fetal nt , maternal serum free beta-hcg and papp-a in trisomy 21 fetuses with absent and present nasal bone was examined .
51
After maternal weight correction , in afro-caribbean women , the median papp-a was increased by 55% and the free beta-hcg increased by 11%. in south asian women , the papp-a was increased by 8% and the free beta-hcg decreased by 7.5%. in oriental women , the papp-a was increased by 9% and the free beta-hcg by 6%. for delta nt in afro-caribbean women , the values were 0.064 mm lower on average than in caucasian women and for south asian women 0.045 mm lower .
52
On average free beta-hcg values are 2.099 times greater in twins than in singletons and papp-a some 1.86 times greater .
53
Preliminary evidence suggests that first-trimester uterine artery doppler measurements do not correlate with maternal serum levels of free beta-hcg and papp-a .
54
To examine whether in pregnancies with fetal trisomy 21 the level of maternal serum free beta-human chorionic gonadotropin ( beta-hcg ) and pregnancy-associated plasma protein-a ( papp-a ) at 11 + 0 to 13 + 6 weeks' gestation is independent of the presence or absence of tricuspid regurgitation and to estimate the performance of a screening test that combines tricuspid regurgitation with fetal nuchal translucency ( nt ) thickness and serum free beta-hcg and papp-a .
55
In this group , free beta-hcg and papp-a did not significantly correlate with uterine artery ri or pi ( r values between -0089 and 0029 , all nonsignificant ) .
56
Using estimates from the literature , a simulation study was undertaken to estimate the performance of tests incorporating , free beta-hcg , total hcg and papp-a at gestations of 8-12 weeks .
57
Regression analysis was performed to determine the significance of the contribution to adverse outcome of reversed a-wave in the ductus venosus , maternal characteristics , fetal delta nuchal translucency , maternal serum log papp-a multiples of the median , and log free beta-hcg multiples of the median .
58
Respective figures for an absent nasal bone in the validation population , which contained fewer black women , were 0.6% , 62.6% , 55.3% , 35.3% and 41.7%. in a screening policy based on maternal age , fetal nt , fhr , serum free beta-hcg and papp-a , for a fixed risk cut-off of 1 : .
59
Using the primary sample of 70,030 pregnancies with a negative outcome , reference bands were constructed for the sonographic parameter fetal nuchal translucency and the biochemical parameters papp-a and free beta-hcg .
60
The estimated risk for trisomy 21 based on maternal age , fetal nt and maternal serum free beta-hcg and papp-a was 1 in 300 or greater in 6.6% ( 233 of 3505 ) of normal pregnancies , in 84.2% ( 16 of 19 ) of those with trisomy 21 and 88.9% ( 24 of 27 ) of those with other chromosomal defects .
61
In women who smoked during the first trimester of pregnancy , papp-a and free beta-hcg levels from dried blood were significantly decreased ( p < 0001 ) and fetal nt thickness was significantly increased ( p < 0001 ) .
62
This study evaluates diagnostic efficacy of papp-a and f beta-hcg in the detection of first trimester pregnancy abnormalities , including down syndrome ( ds ) .
63
Recent spontaneous reduction is associated with higher values of papp-a and free beta-hcg .
64
In contrast , the median mom free beta-hcg was significantly increased ( 205 versus 100 ) with 36% above the 95th centile and papp-a was significantly reduced ( 049 versus 100 ) with 42% below the 5th centile .
65
Adam 12 was correlated with maternal weight ( r ( controls ) = 0.283 ) , papp-a ( r ( controls ) = 0.324 , r ( ds ) = 0.251 ) but less so with free beta-hcg ( r ( controls ) = 0.062 , r ( ds ) = 0.049 ) and delta nt ( r ( controls ) = 0.110 , r ( ds ) = 0.151 ) .
66
In a previous study we examined the changes in the median multiple of the median ( mom ) with gestation of free beta human chorionic gonadotrophin ( f beta-hcg ) , total human chorionic gonadotrophin ( thcg ) , alpha-fetoprotein ( afp ) and pregnancy-associated plasma protein a ( papp-a ) in a large series of down's syndrome pregnancies .
67
In a study of 2923 normal pregnancies and 203 pregnancies affected by trisomy 21 we have shown a significant difference in the median mom of the markers : fetal nuchal translucency , maternal serum free beta-hcg and papp-a in the presence of a female fetus compared with a male fetus .
68
The association between free beta-hcg , papp-a and delta nt and the incidence of preterm delivery before 37 weeks or early preterm delivery before 34 weeks was assessed by comparing the relative incidence at a number of mom or delta nt cut-offs and at various centile cut-offs .
69
Our results ( non-significant lower values of papp-a and significantly higher free beta-hcg values ) were consistent with other reported series .
70
Maternal serum free beta-hcg and papp-a were measured by kryptor , a random access immunoassay analyzer using time-resolved amplified cryptate emission , in 210 singleton pregnancies with trisomy 21 and 946 chromosomally normal controls , matched for maternal age , gestation and sample storage time .
71
Conversely , low levels of papp-a and free beta-hcg as well as increased nuchal translucency were individually associated with increased early loss .
72
In down syndrome the medians were for papp-a 0.63 mom ( 95 per cent confidence interval ( ci ) 0.45-0.87 ) ; free beta-hcg 1.88 mom ( 133-266 ) ; and nt 2.34 mom ( 170-322 ) .
73
To explore if maternal serum free beta-hcg and pregnancy-associated plasma protein a ( papp-a ) levels in the first-trimester of pregnancy are altered in patients with habitual abortions and if there is an effect on first-trimester screening for down syndrome .
74
Free beta human chorionic gonadotrophin ( beta-hcg ) , pregnancy-associated plasma protein ( papp-a ) from materal serum were measured using time resolved fluorescence immunoassay ( trfia ) and fetal nuchal translucency ( nt ) thickness were measured using transabdominal or transvaginal ultrasound. 22 chromosomal defects were diagnosed in 22 cases using karyotyping .
75
To assess the relationship between first-trimester maternal serum papp-a and free beta-hcg and birth weight .
76
Prenatal screening for trisomy 21 was by a combination of maternal serum alpha-fetoprotein ( afp ) and free beta-human chorionic gonadotrophin ( beta-hcg ) in the second trimester and by maternal serum free beta-hcg and pregnancy-associated plasma protein-a ( papp-a ) and fetal nuchal translucency ( nt ) thickness in the first trimester .
77
In 45 cases of trisomy 18 and 493 control pregnancies at 10-14 weeks of gestation , maternal serum inhibin a , total activin a , free beta-hcg and papp-a were measured .
78
The efficiency of six maternal serum markers for down's syndrome ( ds ) , alpha fetoprotein ( afp ) , human chorionic gonadotropin ( hcg ) , free beta-hcg , pregnancy-associated plasma protein-a ( papp-a ) , the proform of eosinophil major basic protein ( prombp ) , pregnancy-specific-beta-1-glycoprotein ( sp(1) ) , and combinations thereof , was examined .
79
There was a statistically significant difference between cases and controls , in the distribution of free beta-hcg and papp-a levels , adjusted for gestation .
80
Screening for trisomy 13 by fetal nuchal translucency and maternal serum free beta-hcg and papp-a at 10-14 weeks of gestation .
81
Fetal nt , maternal serum free beta-hcg , papp-a and cotinine measurements .
82
Early first-trimester free beta-hcg and papp-a serum distributions in monochorionic and dichorionic twins .
83
Logistic regression identified independent associations between spontaneous reduction and both high papp-a and high free beta-hcg .
84
Screening for trisomy 18 using a combination of maternal age , papp-a and free beta-hcg would achieve a detection rate of 76.6 per cent for a false-positive rate of 0.5 per cent .
85
Screening for trisomy 21 in twin pregnancies in the first trimester : does chorionicity impact on maternal serum free beta-hcg or papp-a levels ?
86
In 42 cases of trisomy 13 at 10-14 weeks of gestation , compared with 947 controls , the median multiple of the median ( mom ) of maternal serum free beta-human chorionic gonadotrophin ( beta-hcg ) and pregnancy associated plasma protein a ( papp-a ) was significantly decreased ( 0506 mom and 0248 mom respectively ) , whilst fetal nuchal translucency was increased ( 2872 mom ) .
87
The study included patients with singleton pregnancies who underwent combined first trimester screening using nuchal translucency ( nt ) and maternal serum free beta-human chorionic gonadotrophin ( free beta-hcg ) and papp-a at 10-13 weeks' gestation .
88
This was a multicenter study of prospective screening for trisomy 21 by a combination of fetal nuchal translucency thickness , and maternal serum free beta-hcg and papp-a at 11 + 0 to 13 + 6 weeks of gestation .
89
Extreme values of first-trimester free beta-hcg , papp-a , and nuchal translucency are all associated with adverse outcomes .
90
First , integrated first-trimester screening in all patients and second , first-stage screening of all patients using fetal nt and maternal serum free beta-hcg and papp-a followed by second-stage assessment of tricuspid regurgitation only in those with an intermediate risk of 1 in 101 to 1 in 1000 after the first stage .
91
Screening for trisomy 18 by fetal nuchal translucency and maternal serum free beta-hcg and papp-a at 10-14 weeks of gestation .
92
We examined singleton pregnancies with no chromosomal abnormality and with complete outcome data that had undergone screening for trisomy 21 by a combination of fetal nuchal translucency ( nt ) thickness and maternal serum free beta-human chorionic gonadotropin ( beta-hcg ) and pregnancy-associated plasma protein-a ( papp-a ) at 11 + 0 and 13 + 6 weeks' gestation .
93
This study examines 45 cases of trisomy 13 and 59 cases of trisomy 18 and reports an algorithm to identify pregnancies with a fetus affected by trisomy 13 or 18 by a combination of maternal age fetal nuchal translucency ( nt ) thickness , and maternal serum free beta-hcg and papp-a at 11-14 weeks of gestation .
94
A group of 2110 pregnant women has been screened by maternal age as a background risk , fetal nuchal translucency , nasal bone as ultrasound markers as well as maternal serum level of free beta-subunit human chorionic gonadotropin ( beta-hcg ) and pregnancy-associated plasma protein-a ( papp-a ) as a biochemical markers between 11 - 13+6 weeks of pregnancy from january 2004 to december 2005 .
95
1 ) triple screen-maternal serum alpha fetoprotein , estriol , and hcg ; 2 ) quad-maternal serum alpha fetoprotein , estriol , hcg , and inhibin a ; 3 ) combined first-nuchal translucency , pregnancy-associated plasma protein a ( papp-a ) , free beta-hcg ; 4 ) integrated-nuchal translucency , papp-a , plus quad ; 5 ) serum integrated-papp-a , plus quad ; 6 ) stepwise sequential-combined first plus quad with results given after each test ; and 7 ) contingent sequential-combined first and only those with risk between 1 : 30 and 1 : 1,500 have quad screen .
96
To derive a model and examine the performance of first-trimester combined screening by maternal age , fetal nuchal translucency ( nt ) thickness and maternal serum free beta-human chorionic gonadotropin ( beta-hcg ) and pregnancy-associated plasma protein-a ( papp-a ) .
97
In type ii triploidy fetal nt was not increased ( 088 mom ) , and there was a decrease in maternal serum total hcg ( 016 mom ) , free beta-hcg ( 018 mom ) , papp-a ( 006 mom ) and afp ( 077 mom ) .
98
The median free beta-hcg level in affected pregnancies was 1.79 times the median level for unaffected pregnancies , and the median papp-a level was 0.43 times the normal median .
99
The aim of this study were to determine value and the medians of free beta-human chorionic gonadotropin ( beta-hcg ) and pregnancy associated plasma protein-a ( papp-a ) and nuchal translucency thickness in the first trimester in a prospective study of a non-selected polish population .
100
Monochorionic twins have a significantly lower free beta-hcg weight-corrected mom ( 153 versus 211 ; mann-whitney u , p = 0002 ) and a significantly lower papp-a weight-corrected mom ( 159 versus 240 ; mann-whitney u , p = 0003 ) compared to dichorionic .
101
The purpose of this case-control study was to examine the association of first-trimester concentrations of free beta-human chorionic gonadotropin ( free beta-hcg ) and pregnancy-associated plasma protein a ( papp-a ) in maternal serum with subsequent preterm delivery or small-for-gestational age ( sga ) fetuses .
102
In a population with the maternal age distribution of pregnancies in england and wales , it was estimated that , using the combination of maternal age , fetal nuchal translucency thickness and maternal serum free beta-hcg and papp-a , the detection of trisomy 21 pregnancies would be 89% at a fixed false-positive rate of 5%. alternatively , at a fixed detection rate of 70% , the false-positive rate would be 1%. the inclusion of biochemical parameters added an additional 16% to the detection rate obtained using nt and maternal age alone .
103
Data from two prospective first-trimester oscar screening programmes including 32,010 women with first-trimester maternal serum-free beta-hcg and papp-a measured by the kryptor analyser was analysed by regression analysis to provide parameters for the log-linear and reciprocal-linear mom correction procedures .
104
To investigate the performance of first-trimester screening for aneuploidies by including assessment of the fetal nasal bone in the combined test of maternal age , fetal nuchal translucency ( nt ) thickness , fetal heart rate ( fhr ) and serum free beta-human chorionic gonadotropin ( beta-hcg ) and pregnancy-associated plasma protein-a ( papp-a ) .
105
We estimate that detection rates in excess of 75% for a false positive rate ( fpr ) of 3% can be achieved with first trimester measures of papp-a , total hcg and free beta-hcg at 8 weeks-the addition of total hcg adding 11%. detection rates of around 90% for a fpr of 3% can be achieved through the inclusion of nuchal translucency ( nt ) at 12 weeks to these early first trimester biochemical markers .
106
Fetal karyotype , serum levels of free beta-hcg , pregnancy-associated plasma protein a ( papp-a ) and alpha-fetoprotein and the measurement of nuchal translucency .
107
First trimester screening with free beta-hcg , papp-a and nuchal translucency in pregnancies conceived with assisted reproduction .
108
The combined cases in the first trimester had a median free beta-hcg mom of 0.58 ( 95% ci 0454-0668 ) and a median papp-a mom of 0.26 ( 95% ci 0218-0320 ) .
109
The objective of this study is to determine whether there is an association between the maternal serum concentration of papp-a and free beta-hcg at 11-13 ( +6 ) weeks with the uterine artery pulsatility index ( pi ) at 22-24 weeks , and secondly , to compare the screening characteristics of the two methods in the prediction of adverse pregnancy outcome .
110
To estimate patterns of total hcg and inhibin a levels in the late first trimester of down syndrome pregnancies , compare them with that of free beta-hcg , and assess screening performance of these markers individually and in combination with pregnancy-associated plasma protein-a ( papp-a ) and nuchal translucency .
111
Loss rates were only 0.36% at less than 20 weeks after normal free beta-hcg , papp-a , and nuchal translucency .
112
Total hcg , free beta-hcg and papp-a ( pregnancy associated plasma protein a ) was analysed .
113
The mean multiples of median of pregnancy associated plasma protein a ( papp-a ) , free beta human chorionic gonadotrophin ( beta-hcg ) and nuchal translucency were compared by independent samples t test after logarithmic transformation of the data between smokers and non-smokers .
114
In those pregnancies achieved by ovarian stimulation , neither fetal nt , free beta-hcg nor papp-a were significantly different from the control group .
115
Pregnancy loss rates in women with various levels of papp-a , free beta-hcg , or nuchal translucency ( less than 1st , less than 5th , more than 95th , and more than 99th percentile ) were compared with losses in women with normal values ( 5th to 95th percentile ) .
116
The aim of this study was to evaluate the potential effectiveness of maternal serum pregnancy-associated plasma protein a ( papp-a ) and free beta-hcg in combination with nuchal translucency thickness in first trimester screening for down's syndrome .
117
However , more data are required before the possible reduction in maternal serum free beta-hcg and the reduction of papp-a suggested by the published world series can be considered sufficiently important to take into account in the calculation of risks for chromosomal defects .
118
In the 87 pregnancies with a preterm delivery , the median concentrations of papp-a and free beta-hcg were 0.98 and 0.94 , respectively , compared with 0.99 and 0.99 , respectively , in the 348 matched controls ( p = 082 and 010 , respectively ) .
119
In a first trimester study of 5422 caucasian women , 752 afro-caribbean women and 170 asian women we have shown that the median maternal serum marker moms for free beta-hcg and papp-a were 19% and 48% higher in afro-caribbean women and 19% higher and 35% higher in asian women , compared to caucasian women .
120
Data on maternal smoking status , maternal age , gestational dating , levels of free beta-human chorionic gonadotrophin ( beta-hcg ) and pregnancy-associated plasma protein a ( papp-a ) in maternal blood and fetal nuchal translucency ( nt ) thickness were analyzed from a cohort of 53 114 women .
121
Screening of down's syndrome using a combination of maternal age , papp-a , free beta-hcg and nuchal translucency would achieve a detection rate of 75.8% for a false positive rate of 5% .
122
We retrospectively compared the first trimester down's syndrome serum screening markers free beta-hcg ( fbetahcg ) and pregnancy-associated plasma protein-a ( papp-a ) at 11-14 weeks of gestation in 4,088 women with naturally conceived pregnancies and in women pregnant after icsi ( n = 163 ) , ivf ( n = 59 ) and frozen-thawed embryo transfer ( n = 31 ) , and we searched for a potential relationship between infertility cause and marker levels .
123
We have studied maternal serum free beta-hcg and papp-a , and fetal nuchal translucency ( nt ) in a series of 46 cases of fetal turner's syndrome , 13 cases of other sex chromosomal anomalies and compared these with 947 control pregnancies in the first trimester .
124
To examine the ability of predicting fetuses being small-for-gestational-age ( sga ) at delivery with the maternal serum markers pregnancy-associated plasma protein a ( papp-a ) , beta-human chorionic gonadotrophin ( beta-hcg ) and a disintegrin and metalloprotease 12 ( adam12 ) in first trimester .
125
To study the effect of ethnic chinese on the medians of free beta-hcg and papp-a in the first trimester of pregnancy .
126
Maternal serum free beta-hcg and papp-a were determined at 8 to 12 weeks and fetal nt was measured at 11 to 14 weeks .
127
In the trisomy 21 group there was a small but significant association with papp-a ( r = +01028 ) but not with free beta-hcg ( r = +00339 ) .
128
The normative values and distribution parameters for fetal nt , maternal serum free beta-hcg and papp-a were established in saudi singleton pregnancies , the maternal body weight together with smoking , twin pregnancy and ethnicity being important first-trimester screening co-variables .
129
In 45 monochorionic and 135 dichorionic twin pregnancies the median mom free beta-hcg was not significantly different ( 100 versus 101 ) , whilst that for papp-a was lower ( 089 versus 101 ) but again with no statistical significance .
130
Maternal serum free beta-human chorionic gonadotropin ( beta-hcg ) and pregnancy-associated plasma protein-a ( papp-a ) have been used effectively in the screening of down syndrome in the first trimester .
131
All samples are analysed for free beta-hcg and papp-a before an accurate estimate of gestation is available .
132
In a group of 149 women who had undergone routine first trimester screening using fetal nuchal translucency thickness ( nt ) and maternal serum free beta-hcg and pregnancy associated plasma protein-a ( papp-a ) in two consecutive pregnancies the within person between pregnancy biological variability of these markers has been assessed .
133
Screening for triploidy by fetal nuchal translucency and maternal serum free beta-hcg and papp-a at 10-14 weeks of gestation .
134
In the first trimester of pregnancy , maternal age , fetal nuchal translucency ( nt ) , maternal levels of free beta - human chorionic gonadotropin ( beta-hcg ) and pregnancy-associated plasma protein-a ( papp-a ) are used as screening markers .
135
Of all markers evaluated for first-trimester biochemical screening for down syndrome ( ds ) , papp-a and free beta-hcg emerged as the most predictive .
136
The serum markers pregnancy-associated plasma protein a ( papp-a ) and the free beta-chain of chorionic gonadotrophin ( free beta-hcg ) were both shown to be decreased in the same blood sample .
137
To establish the relationship between the first-trimester screening markers [pregnancy-associated plasma protein a ( papp-a ) , free human chorionic gonadotrophin-beta ( beta-hcg ) , nuchal translucency ( nt ) ] , the down syndrome ( ds ) risk estimate , and the adverse outcomes such as low birth weight , small for gestational age ( sga ) and pre-term delivery .
138
For nt , 93% ( 43/46 ) of cases were equal to or greater than the 95th centile of controls , for papp-a 35% ( 16/46 ) of cases were less than or equal to the 5th centile of controls and for free beta-hcg 15% ( 7/46 ) of cases were equal to or greater than the 95th centile of controls .
139
Nomogrames for free beta-hcg and papp-a levels in physiological pregnancy between 11 ( +0 ) and 13(6) weeks were determined in the examined population .
140
Compared with nonsmoking women , fetal nt was significantly increased and free beta-hcg and papp-a levels were significantly decreased in both cigarette and sheesha smokers .
141
Although these particular serum markers are not useful during the first trimester , the fetoplacental secretory products-free beta-hcg and pregnancy-associated plasma protein-a ( papp-a ) appear to be meaningful clinically when measured between 8 and 13 weeks of gestation , yielding similar first trimester detection rates as the current second trimester screening programme .
142
In affected cases , the value or level of nt and free beta-hcg were higher , while the level of papp-a was lower .
143
For an 85% down's syndrome detection rate , the false-positive rate for the integrated test ( nuchal translucency and pregnancy associated plasma protein-a [papp-a] at 11 completed weeks of pregnancy , and alpha-fetoprotein , unconjugated oestriol [ue3] , free beta or total human chorionic gonadotrophin ( hcg ) and inhibin-a in the early second trimester ) was 0.9% , the serum integrated test ( without nuchal translucency ) 2.7% , the combined test ( nuchal translucency with free beta-hcg and papp-a at 11 weeks ) 4.3% , the quadruple test ( alpha-fetoprotein , ue3 , free beta or total hcg and inhibin-a ) 6.2% , and nuchal translucency at 11 weeks , 15.2%. all tests included maternal age .
144
This was a prospective assessment of singleton pregnancies by maternal history , serum free beta-hcg , pregnancy-associated plasma protein a ( papp-a ) , fetal nuchal translucency thickness , and ductus venosus doppler .
145
In hydatidiform moles , beta-hcg levels are very high demonstrating an intense trophoblastic activity , whereas papp-a levels remain in the normal range .
146
Maternal serum pregnancy-associated plasma protein-a ( papp-a ) and free beta-human chorionic gonadotrophin ( beta-hcg ) are useful markers in the screening of down syndrome in the first trimester .
147
During the five-year study period , 12322 patients with singleton pregnancies underwent combined first-trimester screening using nuchal translucency ( nt ) and maternal serum free beta-human chorionic gonadotrophin ( free beta-hcg ) and pregnancy associated plasma protein-a ( papp-a ) at 10 to 14 weeks' gestation .
148
There were no significant differences in median maternal age , median gestational age , nt delta , free beta-hcg mom and papp-a mom in trisomy 21 fetuses with and without a visible nasal bone , and similarly for those with trisomies 13 or 18 .
149
For maternal serum free beta-hcg mom a significant correlation was observed ( r = 04174 ) as was also found for papp-a mom ( r = 03270 ) .
150
The association between free beta-hcg and papp-a and the incidence of sga were assessed by comparing the relative incidence at mom cut-offs and birth-weight centile cut-offs .
151
Our study population , including 19 ds pregnancies , was evaluated using maternal serum levels of alpha-fetoprotein ( afp ) , beta-human chorionic gonadotropin ( beta-hcg ) , and pregnancy-associated plasma protein a ( papp-a ) .
152
Since we were in the phase of collecting data for the finnish medians for papp-a and beta-hcg , the women were not given the estimates of risk for trisomy 21 .
153
The proportion of false positive results in group of triple markers ( alpha fp , free beta-hcg , papp-a ) was 5%. conclusions : .
154
There is no relationship between tricuspid regurgitation and the levels of maternal serum free beta-hcg and papp-a in cases with trisomy 21 .
155
For free beta-hcg , the log-linear procedure was marginally superior to the reciprocal-linear procedure ( r2 = 0986 v 0980 ) , whilst for papp-a the reciprocal-linear procedure was marginally better ( r2 = 0991 v 0985 ) .
156
To use multiple regression analysis to define the contribution of maternal variables that influence the measured concentration of free beta-human chorionic gonadotropin ( beta-hcg ) and pregnancy-associated plasma protein-a ( papp-a ) , and the interaction between these covariates , in first-trimester biochemical screening for trisomy 21 .
157
To investigate the performance of first-trimester screening for aneuploidies by including assessment of tricuspid blood flow in the combined test of maternal age , fetal nuchal translucency ( nt ) thickness , fetal heart rate ( fhr ) and serum free beta-human chorionic gonadotropin ( beta-hcg ) and pregnancy-associated plasma protein a ( papp-a ) .
158
The performance of first trimester screening using early combinations of total hcg , free beta-hcg and papp-a should be assessed in further studies .
159
Risk assessments for first trimester combined screening are derived from maternal age , ultrasound measurement of fetal nt , maternal serum free beta-hcg and papp-a .
160
The study protocol included first-trimester combined [nuchal translucency ( nt ) , free beta-hcg and pregnancy-associated plasma protein-a ( papp-a ) ] testing .
161
A cohort of saudi women ( first cohort n = 1616 ) with singleton pregnancies prospectively participated in the present study , and fetal nt together with maternal serum free beta-hcg and papp-a were determined at 10 to 13 ( +6 ) weeks of gestation .
162
Performance of free beta-human chorionic gonadotrophin ( free beta-hcg ) and pregnancy associated plasma protein-a ( papp-a ) analysis between delfia xpress and autodelfia systems in the netherlands .
163
First trimester screening for down's syndrome using maternal serum papp-a and free beta-hcg in combination with fetal nuchal translucency thickness .
164
To evaluate the effect of in_vitro fertilization ( ivf ) and intracytoplasmic sperm injection ( icsi ) on free beta-human chorionic gonadotrophin ( beta-hcg ) , pregnancy-associated plasma protein a ( papp-a ) and nuchal translucency ( nt ) .
165
To assess the correlation between first-trimester uterine artery doppler measurements and maternal serum levels of free beta-hcg and pregnancy-associated plasma protein a ( papp-a ) .
166
Screening for trisomy 21 by a combination of maternal age , fetal nuchal translucency ( nt ) thickness and maternal serum free beta-hcg and pregnancy associated plasma protein-a ( papp-a ) at 11-13 ( +6 ) weeks of gestation is associated with a detection rate of 90% , for a false-positive rate of 5%. recent evidence suggests that in about 70% of fetuses with trisomy 21 the nasal bone is not visible at the 11-13 ( +6 ) week scan and that the frequency of absence of nasal bone differs in different ethnic groups .
167
Among the seven cases , five had measurements of maternal serum concentration free beta-hcg and papp-a concentration , yet there were not significant difference between the pregnancies with fetal acrania and those of the control pregnancies ( papp-a , 113 versus 096 ; free beta-hcg , 110 versus 106 ; p > 005 ) .
168
In the pre-eclampsia group , compared to the controls , the uterine artery mean pi and the maternal serum levels of papp-a , free beta-hcg , activin a and inhibin a were significantly increased .
169
The predicted detection rates of pre-eclampsia , for a false positive rate of 5% , was 50% by uterine artery mean pi , 5% by papp-a , 10% by free beta-hcg , 35% by inhibin a and 44% by activin a. screening by a combination of uterine artery mean pi and maternal serum activin a and inhibin a could detect 75% and 92% of patients who subsequently developed pre-eclampsia , for false positive rates of 5% and 10% , respectively .
170
Is there an association between maternal abo and rhesus blood groups and the first-trimester serum markers free beta-hcg and papp-a used for the detection of fetal aneuploidy ?
171
Fetal nt showed a negative relationship with increasing gravidity ( r = -0296 ) or parity ( r = -0311 ) , whereas both free beta-hcg and papp-a exhibited a significant positive relationship .
172
In the trisomy 18 group there was a significant association between pigf and free beta-hcg ( r = +02629 ) but not with papp-a ( r = +00038 ) .
173
Vegf , gly , p , beta-hcg , papp-a , hpl and lif were measured by enxyme-linked immunosorbent assay ( elisa ) methods in a single pre-operative blood sample .
174
In this study we looked at differences in early first-trimester free beta-hcg and papp-a between mono - and dichorionic twins .
175
The medians +/- sd log ( 10 ) mom of papp-a and free beta-hcg +/- sd in patients with and without habitual abortions were 0.063 +/- 0.28 versus - 0.014 +/- 0.27 and - 0.001 +/- 0.27 versus - 0.018 +/- 0.31 , with a p value of 0.042 and 0.87 , respectively .
176
Maternal serum free beta-hcg and papp-a were measured using the kryptor rapid random access immunoassay analyser ( brahms diagnostica ag , berlin ) .
177
Fetal nuchal translucency ( nt ) , maternal serum pregnancy-associated plasma protein a ( papp-a ) , free beta-hcg and the false-positive rate of the test were compared between pregnancies with ( n = 253 ) and without ( n = 2077 ) a history of early vaginal bleeding .
178
First trimester screening using maternal age , nt , free beta-hcg and papp-a is highly effective for the detection of trisomy 21 and is associated with a sensitivity of about 90% for 5% false-positive patients .
179
Patient-specific risks for trisomies 21 , 18 and 13 were calculated by multiplying the age related risk for trisomies 21 , 18 and 13 with the likelihood ratio ( lr ) for fetal nt and with a combined lr for fhr , free beta-hcg and papp-a , respectively .
180
Risk algorithms were developed for the calculation of patient-specific risks for each of the three trisomies based on maternal age , nt , fhr , free beta-hcg and papp-a .
181
Maternal serum adam12 concentration at 11-13 weeks of gestation is unlikely to be useful in first-trimester screening for chromosomal abnormalities because in trisomy 21 the levels are not significantly different from normal , and in the other chromosomal defects , there is a significant association between adam12 and the traditional biochemical markers of free beta-hcg and papp-a .
182
In contrast with the maternal serum analytes used in second-trimester screening--alpha-fetoprotein and human chorionic gonadotropin--this study showed that concentrations of papp-a and free beta-hcg in the first trimester were not associated with subsequent fetal growth retardation or preterm delivery .
183
Of the markers associated with trisomy 18 at this time papp-a was the most discriminatory , being lower than the 5 per cent centile of normal in 93 per cent of cases , compared with 57 per cent of cases for free beta-hcg and 32 per cent of cases for afp .
184
The levels of two potential markers differed between affected and unaffected pregnancies sufficiently to be of value in screening--free beta-hcg and papp-a .
185
Detection rates ( dr ) and false-positive rates ( fpr ) for the nt screening , the double test ( beta-hcg and papp-a ) and the combined test ( nt and the double test ) were calculated using a 1 :
186
First-trimester screening consisted of pregnancy-associated plasma protein a ( papp-a ) , free beta-hcg , and nuchal translucency .
187
First-trimester screening for down syndrome using nuchal translucency measurement with free beta-hcg and papp-a between 10 and 13 weeks of pregnancy--the combined test .
188
In total , 3864 singleton pregnancies with live fetuses at 11-14 weeks were examined and the fetal nt and maternal serum free beta-hcg and papp-a were successfully measured in all cases .
189
Maternal serum biochemistry alone ( papp-a and beta-hcg or alpha-fetoprotein , estriol and beta-hcg ) detects about 65% of aneuploid pregnancies .
190
This two-step second trimester screening will be of value for patients who have not been included in first trimester screening based on nuchal translucency ( nt ) measurement combined with the first trimester markers , papp-a and free beta-hcg .
191
Two first trimester maternal serum screening markers , pregnancy-associated plasma protein-a ( papp-a ) and free beta-human chorionic gonadotropin ( beta-hcg ) , are useful for identifying women at increased risk for fetal down syndrome .
192
When hhcg was combined together with fetal nt , papp-a and maternal age , at a 5% false-positive rate the modeled detection rate was 83% , some 6% lower than when free beta-hcg was used and some 4% better than when thcg was used .
193
Fetal delta-nuchal translucency ( nt ) , maternal serum pregnancy-associated plasma protein a ( papp-a ) and free beta-hcg were compared between pregnancies with ( n = 252 ) and without ( n = 1503 ) an episode of vaginal bleeding .
194
In both the euploid and aneuploid pregnancies , there was a significant association between adam12 and free beta-hcg and papp-a .
195
Data were collected from 1275 pregnant turkish women screened prospectively for chromosomal anomalies to determine whether first-trimester levels of maternal serum pregnancy-associated plasma protein a ( papp-a ) and free beta-human chorionic gonadotropin ( beta-hcg ) and the thickness of nuchal translucency are affected by smoking and other covariables .
196
The measured free beta-hcg and papp-a were converted into a multiple of the median ( mom ) and then into likelihood ratios ( lr ) .
197
Beta-hcg and plac4 mrnas were detected in all samples , in higher amounts than in plasma , whereas the detection rate for papp-a mrna was below 10%. the levels of beta-hcg mrna significantly correlated with the circulatory concentrations of the hcg protein .
198
To examine the potential impact of combining maternal age with fetal nuchal translucency thickness and maternal serum free beta-human chorionic gonadotropin ( beta-hcg ) and pregnancy-associated plasma protein-a ( papp-a ) in screening for trisomy 21 at 10-14 weeks of gestation .
199
To examine the effect of smoking on three first trimester screening markers for down's syndrome that constitute the combined test , namely nuchal translucency ( nt ) , pregnancy-associated plasma protein-a ( papp-a ) and free beta human chorionic gonadotophin ( free beta-hcg ) and to use the results to determine which of these markers need to be adjusted for smoking and by how much .
200
Women with rh-negative blood type have similar first-trimester serum papp-a mom values as rh-positive women , but significantly higher beta-hcg mom values .
201
To establish normative values and distribution parameters of first-trimester screening markers , namely , fetal nuchal translucency ( nt ) , maternal serum free beta-human chorionic gonadotrophin ( beta-hcg ) and pregnancy-associated plasma protein-a ( papp-a ) , at 10 to 13 ( +6 ) weeks of gestation in saudi women and to evaluate the effect of co-variables including maternal body weight , gravidity , parity , fetal gender , twin pregnancy , smoking and ethnicity on these markers .
202
Future strategies for down's syndrome screening may include the use of new markers such as dimeric inhibin-a and urinary beta-core fragment of hcg , as well as first-trimester screening , particularly with papp-a and free beta-hcg .
203
Population modelling using parameters from this and an earlier study showed that a combination of adam 12 and papp-a measured at 8-9 weeks and combined with nt and free beta-hcg measured at 12 weeks could achieve a detection rate of 97% at a 5% false-positive rate or 89% at a 1% false-positive rate .
204
These findings suggest that first trimester biochemical screening for trisomy 21 , which is currently optimised using maternal serum free beta-hcg and papp-a and fetal nuchal translucency , will not benefit from the inclusion of inhibin a .
205
The estimated risk for trisomy 21 based on maternal age , fetal nt and maternal serum free beta-hcg and papp-a was 1 in 300 or greater in 6.8% ( 967 of 14 240 ) normal pregnancies , in 91.5% ( 75 of 82 ) of those with trisomy 21 and in 88.5% ( 54 of 61 ) of those with other chromosomal defects .
206
The standard deviation of the log ( 10 ) mom free beta-hcg was lower in the smoking group and that for papp-a was higher in the smoking group .
207
The vu university medical center ( vumc ) was the first hospital in the netherlands to introduce the delfia xpress for the analysis of free beta-human chorionic gonadotrophin ( beta-hcg ) and pregnancy associated plasma protein-a ( papp-a ) in the first trimester screening program for down syndrome .
208
1.06 nt ( 95% confidence interval 103 to 110 ) , 0.81 papp-a ( 080 to 083 ) and 0.94 free beta-hcg ( 089 to 099 ) .
209
Ethnic chinese have a significantly higher maternal serum level of free beta-hcg and papp-a in the first trimester , which could not be explained by differences in maternal weight .
210
There is no relationship between an absent fetal nasal bone and the levels of maternal serum papp-a or free beta-hcg in cases with trisomies 13 , 18 or 21 .
211
In type i triploidy there was increased fetal nt ( 276 mom ) , maternal serum total hcg ( 491 mom ) , free beta-hcg ( 804 mom ) , and afp ( 322 mom ) , and mildly decreased papp-a ( 075 mom ) .
212
The rate of fetal loss increased with decreasing maternal serum free beta-hcg and papp-a and increasing delta nt .
213
Maternal serum free beta-hcg , papp-a and fetal nt were measured in 9762 women presenting for first-trimester combined screening for down syndrome at 11 to 14 weeks of gestation .
214
The likelihood ratio profiles provided at various levels of papp-a or free beta-hcg may be of some help in counseling women with such results and raise awareness among health-care professionals for increased surveillance in such cases .
215
The median shift observed for afp and total hcg is poorer than that for pregnancy associated plasma protein-a ( papp-a ) or free beta-hcg and together with maternal age , afp and total hcg could only be expected to detect 40% of cases .
216
Maternal weight correction of maternal serum papp-a and free beta-hcg mom when screening for trisomy 21 in the first trimester of pregnancy .
217
Maternal blood levels of beta-hcg- , plac4 - and papp-a mrnas are not useful markers for the screening of pregnancies with trisomy 21 as their concentrations are either not significantly altered ( beta-hcg and plac4 ) or too low to be detected ( papp-a ) .
218
Smoking decreased mom values of free beta-hcg ( by 146% ; p < 001 ) and papp-a ( by 188% ; p < 0001 ) .
219
In the case of monochorionic and dichorionic twins the median weight corrected , ethnicity corrected , smoking corrected and ivf corrected , free beta-hcg mom's were not significantly different ( 1983 v 2041 ) , however for papp-a the median weight corrected , ethnicity corrected , smoking corrected and ivf corrected mom in monochorionic twins was significantly lower than in dichorionic twins ( 1756 v 2250 ) whilst the sd log ( 10 ) mom's were not significantly different ( 02185 v 02167 ) .
220
Using a previously derived multivariate risk algorithm for trisomy 21 , incorporating nt , papp-a , free beta-hcg and maternal age , 96% of the turner's cases and 62% of the other sex chromosomal anomalies would have been identified .
221
The average within person biological variation for free beta-hcg was 21% and 32% for papp-a .
222
We have studied changes in first trimester fetal nuchal translucency ( nt ) and maternal serum free beta-hcg and papp-a with gravidity and parity in 3252 singleton pregnancies unaffected by chromosomal abnormality or major pregnancy complications .
223
For a 5% false-positive rate , the sensitivities are approximately 30% for maternal age alone , 60-70% for maternal age and second-trimester maternal serum biochemical testing , 75% for maternal age and first-trimester fetal nuchal translucency ( nt ) scanning , and 90% for maternal age with fetal nt and maternal serum free beta-human chorionic gonadotropin ( beta-hcg ) and pregnancy-associated plasma protein-a ( papp-a ) at 11-14 weeks .
224
In this study , we tested the equality of measurements for free beta-hcg and papp-a between delfia xpress systems and one autodelfia system .
225
We examined 54 722 singleton pregnancies with no chromosomal abnormality and with complete outcome data that had undergone screening for trisomy 21 by a combination of fetal nuchal translucency ( nt ) thickness and maternal serum free beta-human chorionic gonadotropin ( beta-hcg ) and pregnancy-associated plasma protein-a ( papp-a ) at 11 + 0 and 13 + 6 weeks' gestation .
226
There was almost no correlation between reduced levels ( papp-a and reduced levels of free beta-hcg in either the normal pregnancy group ( r = 0041 ) or the group with fetal death ( r = 0072 ) , indicating relatively independent prediction by either biochemical marker .
227
Fetal nuchal translucency thickness ( fetal nt ) , maternal serum free beta-human chorionic gonadotrophin ( free beta-hcg ) and pregnancy-associated plasma protein-a ( papp-a ) were measured at 11 weeks 0 days to 13 weeks 6 days of gestation in all women .
228
The measured free beta-hcg and papp-a were converted into a multiple of the median ( mom ) for gestational age , adjusted for maternal weight , ethnicity , smoking status , method of conception and parity , and a likelihood ratio was subsequently calculated .
229
The median pregnancy associated plasma protein-a ( papp-a ) in this trisomy 21 series was 0.49 and for free beta-hcg was 2.05 .
230
The present paper compares the plasma concentrations of papp-a with the levels of two trophoblastic proteins , human placental lactogen ( hpl ) and the beta-subunit of human chorionic gonadotrophin ( beta-hcg ) , with a steroid of fetoplacental origin , total oestriol ( total e3 ) , and with a fetal protein , alpha-fetoprotein ( afp ) .
231
A multicentre study ( the first trimester serum screening study ) has shown that there are two biochemical markers of choice at this time in pregnancy , namely pregnancy associated placental protein a ( papp-a ) and the free beta-sub-unit of human chorionic gonadotrophin ( free beta-hcg ) .
232
A 30-year-old woman , gravida 2 , para 1 , was referred for nuchal translucency , free beta-human chorionic gonadotropin ( beta-hcg ) , and pregnancy-associated plasma protein a ( papp-a ) screening at 12 weeks gestation .
233
To establish normative values and distribution parameters of first-trimester maternal serum free beta-human chorionic gonadotropin ( beta-hcg ) , pregnancy-associated plasma protein-a ( papp-a ) and fetal nuchal translucency ( nt ) thickness in chinese women and to examine the effects of covariates on their levels .
234
There were no significant differences in geometric mean mom free beta-hcg and papp-a between pregnancies with an early ( gestational week <9 , evt ) or late vanishing twin ( gestational week 9-13 , lvt ) or singleton pregnancies ( 098 , 113 and 095 for free beta-hcg and 084 , 080 and 074 for papp-a , respectively ) .
235
In this prospective study , three-dimensional ( 3d ) volumes of the fetal head were obtained from 500 pregnancies before fetal karyotyping by chorionic villus sampling ( cvs ) , after screening by fetal nuchal translucency ( nt ) thickness and maternal serum free beta-human chorionic gonadotropin ( beta-hcg ) and pregnancy-associated plasma protein-a ( papp-a ) at 11 + 0 to 13 + 6 weeks .
236
To determine the performance of screening for down syndrome ( ds ) and other major chromosomal abnormalities using nuchal translucency ( nt ) , free beta-human chorionic gonadotropin ( beta-hcg ) and pregnancy-associated plasma protein-a ( papp-a ) in a prospective study of a non-selected population .
237
The mean +/- sd log ( 10 ) mom for nt , papp-a and free beta-hcg was -0.024 +/- 0.101 , 0.007 +/- 0.244 , 0.047 +/- 0.273 and -0.011 +/- 0.108 , -0.006 +/- 0.223 , 0.008 +/- 0.264 in pregnancies with and without a history of early vaginal bleeding , with a p value of 0.07 , 0.40 and 0.03 respectively .
238
Recent nice guidelines have emphasized the need to have in place by 2007 the capability of offering screening to all women in the first trimester using a combination of maternal age with the ultrasound marker nuchal translucency thickness ( nt ) and the maternal serum biochemical markers free beta-hcg and pregnancy-associated plasma protein-a ( papp-a ) .
239
Multivariate regression analysis indicated that free beta-hcg mom was statistically significantly dependent on maternal weight ( p < 00001 ) and chorionicity in twin pregnancy ( both monochorionic and dichorionic p < 00001 ) , that papp-a mom was dependent on maternal weight ( p < 00001 ) , parity ( p < 00001 ) , chorionicity in twin pregnancy ( both monochorionic and dichorionic p < 00001 ) and mode of conception ( p = 0002 ) , and that fetal nt-mom was dependent on maternal weight ( p = 00006 ) and mode of conception ( p = 0012 ) .
240
Screening in the first trimester of pregnancy ( between 10 and 13 weeks of pregnancy ) is possible using two biochemical markers ( papp-a and free beta-hcg ) together with an ultrasound marker nuchal translucency measurement ; using these three markers together with maternal age can identify 85% of affected pregnancies , with a 5% false-positive rate .
241
Using a fixed screen-positive rate ( spr ) of 5% , the first-trimester combined test [nuchal translucency ( nt ) , papp-a and free beta-hcg] yielded a detection rate ( dr ) of 76% , and the integrated test ( nt , papp-a , afp , hcg , ue3 and inhibin a ) yielded a dr of 86%. with a dr of 90% , the best combination was the first-trimester beta-hcg and nt with the second-trimester prombp and afp .
242
Maternal serum hhcg levels were not correlated with fetal nt but showed significant correlation with thcg and free beta-hcg and with papp-a in the down syndrome group ( r = 0536 ) .
243
To assess whether there is a need to correct first-trimester biochemical markers ( free beta-hcg and pregnancy-associated plasma protein-a ( papp-a ) ) or first-trimester fetal nuchal translucency thickness ( nt ) in different ethnic groups , when screening for downs syndrome at 11-14 weeks of gestation .
244
Screening for trisomy 21 by a combination of maternal age , fetal nuchal translucency ( nt ) thickness and maternal serum free beta-hcg and pregnancy-associated plasma protein-a ( papp-a ) at 11 to 14 weeks of gestation is associated with a detection rate of 90% for a false-positive rate of 5%. recent evidence suggests that in about 70% of fetuses with trisomy 21 , the nasal bone is not visible at the 11th - to 14th-week scan ( cicero et al , 2001 ) .
245
Results for inhibin , activin , papp-a and free beta-hcg were available from previous studies .
246
To evaluate the performance of first-trimester screening for trisomy 21 by a combination of maternal age , fetal nuchal translucency ( nt ) and maternal serum free beta-human chorionic gonadotropin ( beta-hcg ) and pregnancy-associated plasma protein-a ( papp-a ) .
247
The respective values for beta-hcg mom were 1.003 for smokers and 1.035 for nonsmokers ( p < 00001 for log ( 10 ) mom ) which corresponds to a reduction of 3.1%. there was a significant inverse relationship between the number of cigarettes per day and the level of papp-a mom ( r = 0989 , p < 00001 ) but not the level of free beta-hcg mom ( r = 0733 ; p = 0098 ) .
248
To evaluate the influence of cigarette smoking status on maternal serum free beta-hcg , papp-a and fetal nuchal translucency ( nt ) thickness at 11 to 14 weeks of gestation in a large cohort of women screened prospectively for chromosomal anomalies .
249
We conclude that a large proportion of triploidy cases of both phenotypes could be identified in the first trimester using nt , maternal serum free beta-hcg and papp-a with a combination of trisomy 21 risk and an atypicality approach .
250
The odds ratios ( or ) of adverse outcomes were analysed for combined risk incorporating maternal age , nuchal translucency ( nt ) and biochemical parameters and then separately for each parameter ( pregnancy-associated plasma protein-a ( papp-a ) , free beta human chorionic gonadotropin ( beta-hcg ) and nt ) .
251
The median beta-hcg level decreased significantly as gravidity and parity increased ; no effect was noted on papp-a .
252
In cases of turner's syndrome ( 45 , x ) the median fetal nt was significantly higher than in controls ( 476 mom ) , the median papp-a was significantly lower ( 049 mom ) , whilst the free beta-hcg was not significantly different ( 111 mom ) .
253
Spontaneous reduction was associated with a higher frequency of papp-a >95th %ile ( 171 versus 47% ; p = 003 ) and free beta-hcg >95th %ile ( 171% versus 50% ; p = 004 ) .
254
There was no significant association between the fmf angle and fetal nt or serum papp-a or beta-hcg .
255
Beta-hcg , pregnancy-specific glycoproteins , human placental lactogens , pregnancy-associated plasma protein a ( papp-a ) ] .
256
In 38% and 71% of cases of trisomy 13 maternal serum free beta-hcg and papp-a was below the 5th centile of the appropriate normal range for gestation and in 62% of cases the nuchal translucency was above the 95th centile .
257
Measurement of nuchal translucency ( nt ) alone ; serum screening ( pregnancy-associated plasma protein a [papp-a] and free beta subunit of human chorionic gonadotropin [beta-hcg] ) alone ; and combined screening ( nt plus papp-a and free beta-hcg ) .
258
A first trimester trisomy 13/trisomy 18 risk algorithm combining fetal nuchal translucency thickness , maternal serum free beta-hcg and papp-a .
259
Fluorimetric immunoassays for free beta-hcg and papp-a .
260
Over the past three years approximately 12 000 women have been screened in the first trimester through our oscar programme , which utilizes fetal nt and maternal serum free beta-hcg and papp-a .
261
Significant contributions in the prediction of trisomy 21 were provided by maternal age , serum plgf , papp-a and free beta-hcg , and the detection rates of screening with the combination of these variables were 70% and 80% at respective false-positive rates of 3% and 5%. conclusions : .
262
However , the absence of ultrasound features of fetal anemia and hydropic changes , together with normal maternal serum free beta-hcg and papp-a in the first trimester , will be reassuring signs of normality for fetuses at risk of homozygous alpha0-thalassemia and , hence , enable women to avoid invasive tests in unaffected pregnancies .
263
Integrated ultrasound and biochemical screening for trisomy 21 using fetal nuchal translucency , absent fetal nasal bone , free beta-hcg and papp-a at 11 to 14 weeks .
264
Previous studies have shown an association between low first trimester maternal serum free beta-hcg and papp-a and subsequent development of pregnancy complications .
265
There was a significant inverse association between the risk for sga and maternal serum papp-a mom but not free beta-hcg mom .
266
The overall median weight corrected , ethnicity corrected , smoking corrected and ivf corrected mom amongst twin pregnancies were 2.023 for free beta-hcg ( sd log ( 10 ) mom = 0.2611 and 2.121 for papp-a ( sd log ( 10 ) mom = 02255 ) - - both medians were significantly greater than the medians in singleton pregnancies ( 100 mom ) .
267
To examine the levels of free beta-human chorionic gonadotrophin ( free beta-hcg ) and pregnancy-associated plasma protein-a ( papp-a ) in second-trimester maternal serum from pregnancies affected by trisomy 13 and compare these with the known reduced levels of these markers in first-trimester cases in an attempt to better understand the pathophysiology of changes in marker levels in chromosomally abnormal pregnancies between the first and second trimester .
268
The detection rate of down syndrome with nt measurement was 77.8% ( 7/9 ) with a false-positive rate of 4.5%. incorporation of biochemical tests ( papp-a , and free beta-hcg measurement ) into the screening increased the detection rate to 88.9% ( 8/9 ) and decreased the false-positive rate to 3.6%. the prevalence of absent nasal bone was 7/1,798 ( 039% ) in chromosomally normal fetuses , and 3/9 ( 333% ) in down syndrome fetuses .
269
In the pregnancies subsequently found to have trisomy 21 and in those with no obvious chromosomal abnormality , we used multiple regression analysis to account for pregnancy characteristics that influence the measured concentrations of free beta-hcg and papp-a .
270
In a screening policy based on maternal age , fetal nt , fhr , serum free beta-hcg and papp-a , for a fixed false positive rate of 3% the standardized detection rates were 91% for trisomy 21 and 100% for trisomy 18 , trisomy 13 and turner syndrome .
271
Fmf software generated all risk assessments based on nuchal translucency ( nt ) , maternal serum-free beta human chorionic gonadotropin ( beta-hcg ) and pregnancy-associated plasma protein a ( papp-a ) .
272
Maternal serum free beta-hcg and papp-a were measured using the kryptor rapid random-access immunoassay analyser ( brahms diagnostica gmbh , berlin ) .
273
Proposed protocols based on first-trimester nt , papp-a and free beta-hcg or total hcg , followed by selective use of second-trimester quadruple markers can result in a 91% detection rate and 2.1% false-positive rate for the united kingdom and a detection rate of 89% and false-positive rate of 3.1% for the united states .
274
There were no significant differences in median maternal age , median gestational age , nt delta , free beta-hcg mom and papp-a mom in trisomy 21 fetuses with and without a visible nasal bone .
275
Women were offered screening using a combination of maternal serum free beta-hcg and pregnancy associated plasma protein-a ( papp-a ) and fetal nuchal translucency thickness .
276
The median maternal weight corrected free beta-hcg and papp-a , expressed as multiple of the median ( mom ) , and fetal nt , expressed as delta values , in the iddm and non-iddm groups were compared .
277
On average , free beta-hcg was increased by 10% in a subsequent pregnancy after aneuploidy ( p < 0005 , wilcoxon rank sum test ) and for papp-a the increase was 15% ( p < 00001 ) .
278
To investigate the potential value of combining uterine artery doppler ultrasonography with the measurement of maternal serum pregnancy-associated plasma protein-a ( papp-a ) , free beta-human chorionic gonadotropin ( beta-hcg ) , activin a and inhibin a at 22 + 0 to 24 + 6 weeks' gestation , in the prediction of pregnancies that subsequently develop pre-eclampsia .
279
We demonstrate an excellent agreement for the analysis of papp-a and free beta-hcg between delfia xpress systems and one autodelfia system .
280
In digynic triploidy , free beta-hcg was 0.16 ( range 002-095 ) mom and papp-a was 0.06 ( range 002-047 ) mom and the respective values for diandric triploidy were 8.74 ( range 283-470 ) and 0.74 ( range 032-151 ) mom .
281
We compared these levels with those of other potential first trimester serum markers [free beta-hcg , pregnancy-associated plasma protein a ( papp-a ) and total hcg ( thcg ) ] and modeled detection rates and false-positive rates of various biochemical markers in conjunction with fetal nuchal translucency ( nt ) and maternal age using an maternal age standardized population .
282
Combining nuchal translucency measurement with papp-a and free beta-hcg assay ( first trimester combined screening ) increases the sensitivity up to 82%. the most specific strategy is based on the integrated test , i.e. , the integration of the quadruple test performed in second trimester ( inhibine dimeric a , total beta-hcg , afp , and ue3 assay ) to the first trimester combined screening : .
283
In the trisomy 18 pregnancies the median values were 0.74 mom for inhibin a , 1.23 mom for activin a , 0.38 mom for free beta-hcg and 0.16 mom for papp-a .
284
In the first trimester of pregnancy the biochemical markers free beta-hcg and pregnancy associated plasma protein-a ( papp-a ) are used for the prenatal screening of trisomy 21 , either alone or in combination with nuchal translucency ( nt ) thickness .
285
Inhibin a levels in affected pregnancies were compared with levels of free beta-hcg and papp-a in the same series .
286
The nuchal translucency was increased to 3.8 mm , resulting in a post-test result of 1 : 15 risk for down syndrome by a combination of maternal age plus nuchal translucency , and 1 : 5 by a combination of maternal age plus nuchal translucency plus free beta-hcg plus papp-a .
287
At 12 weeks , the multivariate detection rates at a 5% false-positive rate for nuchal translucency and papp-a ( with maternal age ) with either free beta-hcg , total hcg , or inhibin a were 84% , 83% , and 85% , respectively .
288
All women completed a first trimester combined ultrasound and biochemical screening programme comprising serum papp-a and free beta-hcg together with nuchal translucency ( nt ) measurement .
289
In this mixed trisomy group the median mom nt was increased at 2.819 , whilst the median moms for free beta-hcg and papp-a were reduced at 0.375 and 0.201 respectively .
290
This study compares the circulating concentrations of papp-a and beta-hcg and progesterone in different pathological situations .
291
Maternal weight correction in the first trimester using free beta-hcg and papp-a can be best achieved using the log-linear procedure .
292
To examine the effectiveness in screening for triploidy at 11 weeks to 13 weeks and 6 days of gestation by the combined use of the risk algorithms for trisomies 21 , 18 and 13 based on maternal age , fetal nuchal translucency ( nt ) thickness , fetal heart rate ( fhr ) and maternal serum free beta-hcg and papp-a .
293
Concentrations of free beta-hcg and papp-a were expressed in multiples of the median ( mom ) for gestational age .
294
Correlation with previously analysed markers ( papp-a , free beta-hcg and delta nt ) was performed .
295
Afp and total hcg are not likely to replace the markers free beta-hcg and papp-a in first trimester screening for chromosomal anomalies .
296
For maternal serum free beta-hcg mom a significant correlation was found ( r = 03976 , p < 0001 ) , as was also found for papp-a mom ( r = 04371 , p < 0001 ) .
297
To examine the efficacy of first trimester screening for trisomy 21 using a combination of maternal age , fetal nuchal translucency ( nt ) , maternal serum free beta-human chorionic gonadotropin ( free beta-hcg ) and pregnancy-associated plasma protein a ( papp-a ) in a regional setting [maternity unit of the women's university hospital , hannover medical school ( study center ) ; two regional private centers for prenatal diagnosis and human genetics ; laboratory for prenatal diagnosis and human genetics] .
298
In the pre-eclampsia group the median papp-a mom was significantly reduced ( 0772 mom , p < 00001 ) whilst the median free beta-hcg mom was not different from controls ( 0981 mom , p = 026 ) .
299
The proportion of evt pregnancies with a papp-a and free beta-hcg log ( 10 ) mom value below the 5th%iles and above the 95th%iles of the value in the singleton pregnancies were 4.3% , 4.3% , 6.4% and 8.5% , respectively , which did not constitute a significant difference from singletons .
300
Women booked into the clinic were offered screening using a combination of maternal serum free beta-hcg and pregnancy-associated plasma protein-a ( papp-a ) and fetal nuchal translucency thickness .
301
This approach is unlikely to be better than the excellent detection rates achievable with free beta-hcg , papp-a and nuchal translucency in the first trimester .
302
In a study of 180 twin pregnancies i have examined the distribution of maternal serum free beta-human chorionic gonadotrophin ( beta-hcg ) and pregnancy-associated plasma protein-a ( papp-a ) , in addition to fetal nuchal translucency thickness ( nt ) , in twins classified as monochorionic or dichorionic , based on ultrasound appearance at 10-14 weeks of gestation .
303
Although levels of free beta-hcg in affected pregnancies were higher earlier than the levels of either total hcg or inhibin a , there was no significant difference in screening performance when either of the three markers was used with nuchal translucency and papp-a at 11-13 weeks of pregnancy .
304
Our objective was to examine the performance of first-trimester screening for trisomies 21 , 18 and 13 by maternal age , fetal nuchal translucency ( nt ) thickness , fetal heart rate ( fhr ) and maternal serum-free beta-hcg and pregnancy-associated plasma protein-a ( papp-a ) .
305
In the group with down syndrome , the median mom free beta-hcg was not significantly different in the smokers ( 169 versus 186 ) as was that for papp-a ( 053 versus 057 ) .
306
Index i ( weeks 7-9 ) = 0.52 logmom prombp + 0.28 logmom papp-a - logmom sp(1) ; index ii ( weeks 10-12 ) = 1.94 logmom free beta-hcg - logmom sp(1) , and index iii ( weeks 15-19 ) = 0.78 logmom free beta-hcg + 1.12 logmom prombp - logmom afp .
307
In ivf pregnancies , screening for trisomy 21 by fetal nt , maternal serum free beta-hcg and papp-a levels may be associated with a 1.2% higher false-positive rate than in natural conception .
308
To evaluate whether first-trimester levels of papp-a and serum free-beta-human chorionic gonadotrophin ( free beta-hcg ) vary with maternal blood group and rhesus status and to assess whether this has implications for first-trimester screening for chromosomal anomalies .
309
We assessed the discriminatory efficiency and cost-effectiveness of a novel way of organising first trimester screening for down syndrome ( ds ) , contingent testing , where a serological test ( papp-a and beta-hcg :
310
Mean maternal age was 33 +/- 4. nt , free beta-hcg and papp-a values of the control cases were not significantly different from local standards evaluated on 3043 cases .
311
Combining pp13 bivariately with any of the markers ( pi , papp-a , activin , inhibin or free beta-hcg ) tested in the 22-24 week period did not improve the detection of early , late or all cases of pre-eclampsia compared with either marker alone .
312
In the intracytoplasmic sperm injection group , fetal nt and free beta-hcg values were not significantly different from those in controls , but papp-a was significantly decreased .
313
Early prediction of fetuses being sga is feasible with the combination of first trimester papp-a , beta-hcg and adam12 .
314
The data of 200 twins with normal outcome were used for setting up reference values for free beta-hcg and papp-a .
315
Plasma levels of alpha-fetoprotein ( afp ) , pregnancy-associated plasma protein-a ( papp-a ) and free human chronic gonadotrophin beta-subunit ( beta-hcg ) were compared with those in maternal serum .
316
Maternal serum free beta-hcg and papp-a in fetal sex chromosome defects in the first trimester .
317
Maternal serum concentrations of free beta-hcg and papp-a were determined by microtiter-plate elisa .
318
For an 85% down's syndrome detection rate , the false-positive rate for the integrated test ( nuchal translucency and pregnancy associated plasma protein-a [papp-a] at 11 completed weeks of pregnancy , and alpha-fetoprotein , unconjugated oestriol [ue(3) ] , free beta or total human chorionic gondaotrophin ( hcg ) and inhibin-a in the early second trimester ) was 0.9% , the serum integrated test ( without nuchal translucency ) 2.7% , the combined test ( nuchal translucency with free beta-hcg and papp-a at 11 weeks ) 4.3% , the quadruple test ( alpha-fetoprotein , ue(3) , free beta or total hcg and inhibin-a ) 6.2% , and nuchal translucency at 11 weeks , 15.2%. all tests included maternal age .
319
The overall median weight-corrected mom was 1.99 for free beta-hcg , and 2.14 for papp-a in all twins .
320
Gaslini' institute for antenatal care , we evaluated first-trimester risk screening for down syndrome using the 'combined test' based on ultrasound measurement of nuchal translucency ( nt ) , maternal serum pregnancy-associated plasma protein a ( papp-a ) and free beta-hcg , and maternal age .
321
The present study focused on measurements of beta-hcg and papp-a in the sera of women with rh-negative blood group .
322
Nt was measured according to the criteria set by the fetal medicine foundation ( fmf ) , maternal serum free beta-hcg and papp-a levels were measured , and the risk of trisomy 21 was calculated using the fmf's algorithm .
323
There were no significant differences in median maternal age , median gestational age , free beta-hcg multiples of the median ( mom ) and papp-a mom in trisomy 21 fetuses with and without tricuspid regurgitation .
324
Using the kryptor immunoassay system , we measured free beta-hcg and papp-a in 32 singleton pregnancies affected by trisomy 13 between 14 and 20 weeks of gestation .
325
Low levels of maternal serum papp-a and free beta-hcg and increased fetal nt are associated , in the absence of an abnormal karyotype , with an increased risk of impending fetal death .
326
Early pregnancy screening with the combined measurement of maternal serum papp-a and free beta-hcg and fetal nuchal translucency could achieve a high down syndrome detection rate .
327
The distribution of maternal serum free beta-hcg and papp-a in chromosomally abnormal fetuses with absent and present nasal bone was examined .
328
In the ivf pregnancies , the median fetal nt was not significantly different from that in controls , whilst the median free beta-hcg was significantly increased , and papp-a was significantly decreased .
329
The median mom in affected pregnancies was 0.25 for papp-a and 0.34 for free beta-hcg .
330
With the association of some biochemical markers like maternal serum free beta-human chorionic gonadotropin ( beta-hcg ) and pregnancy-associated plasma protein-a ( papp-a ) to ultrasonography at 11-14 weeks , it is possible to identify about 90% of chromosomal abnormalities .
331
With spontaneous abortions , beta-hcg levels decline to very low values whereas papp-a continues to increase .
332
Women booked into the clinic were offered screening , using a combination of maternal serum free beta-hcg and pregnancy-associated plasma protein-a ( papp-a ) and fetal nuchal translucency thickness .
333
Pregnancies with fetal ntds were evaluated and their maternal serum levels of free beta-hcg and papp-a were compared with those of the normal control pregnancies .
334
Fetal nt , crown-rump length , maternal serum free beta-hcg and papp-a were measured at 11-14 weeks of gestation .
335
Fetal nt and maternal serum free beta-hcg and papp-a were successfully measured in all cases .
336
Down syndrome screening was performed using a combination of maternal age , fetal nuchal translucency , and maternal serum concentrations of free beta-hcg and papp-a during the period of 10-14 weeks' gestation .
337
The maternal serum levels of multiples of median of free beta-hcg and papp-a were significantly higher among the chinese than among the caucasians .
338
Modelling the detection rate for a 3 or 5% false-positive rate when screening using intact hcg , free beta-hcg and papp-a at 8-10 weeks of gestation indicated that 71 or 77% of cases would be detected .
339
To evaluate the influence of maternal insulin dependent diabetes mellitus ( iddm ) on maternal serum free beta-hcg , papp-a and fetal nuchal translucency ( nt ) , thickness at 11 to 13 ( +6 ) weeks of gestation in a large cohort of women screened prospectively for chromosomal anomalies .
340
The difference in the median multiple of the median ( mom ) values in smokers compared to non-smokers was determined for nt , papp-a and free beta-hcg in 12,517 unaffected pregnancies that had routine first trimester combined test screening .
341
In first-trimester screening for down syndrome by maternal serum papp-a and free beta-hcg the impact of correcting for the dose dependant rather than the all or nil effect of smoking is marginal .
342
The influence of fetal sex in screening for trisomy 21 by fetal nuchal translucency , maternal serum free beta-hcg and papp-a at 10-14 weeks of gestation .
343
Prospective screening for trisomy 21 by maternal age , fetal nt , free beta-hcg and papp-a at 11 ( +0 ) -13 ( +6 ) weeks in singleton pregnancies , including 56 376 normal cases , 395 with trisomy 21 , 122 with trisomy 18 and 61 with trisomy 13 .
344
Fetal nt and maternal serum free beta-hcg and papp-a were successfully measured in all cases .
345
There were no significant differences between the iddm and non-iddm groups in median maternal weight corrected free beta-hcg ( iddm 087 mom , 95% confidence interval 075 to 116 mom , non-iddm 100 mom ) , median maternal weight corrected papp-a ( iddm 102 mom , 95% confidence interval 083 to 105 mom , non-iddm 101 mom ) , or mean delta nt ( iddm 00358 mm , non-iddm 00002 mm ) .
346
Maternal serum levels of free beta-hcg and papp-a .
347
The within-run precision with buffer-based calibrators was below 8% over the working range of papp-a ( 40-10000 miu/l ) and beta-hcg ( 73-525 micrograms/l ) and no hook effect was observed .
348
To determine the levels of free beta-human chorionic gonadotrophin ( beta-hcg ) and pregnancy-associated plasma protein a ( papp-a ) in twin pregnancies in the first trimester .
349
The association between free beta-hcg , papp-a and delta nt and the incidence of fetal loss prior to 24 weeks , at or after 24 weeks or at any time , was assessed by comparing the relative incidence at a number of mom or delta nt cut-offs and at various centile cut-offs .
350
Maternal body weight was corrected , particularly for maternal free beta-hcg and papp-a using standard methods .
351
We examined 2 screening strategies ; first , integrated first-trimester screening in all patients and second , first-stage screening of all patients using fetal nt and maternal serum free beta-hcg and papp-a , followed by second-stage assessment of nasal bone only in those with an intermediate risk of 1 in 101 to 1 in 1000 after the first-stage .
352
The modeled detection rates of trisomy 21 for fixed false positive rates of 1% , 2% and 5% in screening by maternal age , fetal nt thickness and maternal serum free beta-hcg and papp-a and assessment of tricuspid flow in all cases were 87% , 90% and 95%. in the two-stage approach , the estimated detection rate was 91% and the false positive rate was 2.6%. conclusions : .
353
Cigarette and sheesha smoking significantly affect first-trimester markers of down syndrome ( fetal nt , free beta-hcg and papp-a ) .
354
The purpose of the present study was to evaluate whether a gender-related difference exists in first trimester markers used for down syndrome screening , namely nuchal translucency ( nt ) , maternal serum pregnancy-associated plasma protein-a ( papp-a ) , and free beta-human chorionic gonadotrophin ( beta-hcg ) , and whether this has an influence on screening performance .
355
When maternal serum free-beta human chorionic gonadotrophin ( beta-hcg ) and pregnancy-associated plasma protein-a ( papp-a ) at 11-14 weeks are also taken into account , the detection rate of chromosomal defects is about 90%. increased nt can also identify a high proportion of other chromosomal abnormalities and is associated with major defects of the heart and great arteries , and a wide range of skeletal dysplasias and genetic syndromes .
356
When simulating the performance of papp-a and age as markers for ds in population screening a detection rate ( dr ) of 62% was found for a screen positive rate ( spr ) of 5%. together with beta-hcg and nuchal translucency , two other first trimester markers for fetal ds , a dr 90% could be obtained for an spr of 5% .
357
Free beta-hcg mom was less than the 5th centile of normal in 64 per cent of cases of trisomy 18 and for papp-a was less than the 5th centile in 78 per cent of cases .
358
In the unaffected population , the median free beta-hcg mom was significantly lower in the smoking group ( 097 versus 100 ) as was that for papp-a ( 084 versus 102 ) .
359
Type i , characterized by extremely high levels of free beta-hcg and elevated nt ; and type ii , characterized by very low levels of papp-a and free beta-hcg with normal nt .
360
At a false positive rate ( fpr ) of 5 per cent , the detection rate ( dr ) for ds is 9 per cent for beta-hcg , 18 per cent for afp , and 66 per cent for papp-a when considering these parameters individually .
361
The relationships between free beta-hcg and papp-a were excellent for the different delfia xpress systems ( r > 099 , p < 00001 ) .
362
There was a significant positive correlation between birth weight and papp-a , but not free beta-hcg levels .
363
A serum screening result ( age , pregnancy-associated plasma protein-a ( papp-a ) and free beta-human chorionic gonadotropin ( beta-hcg ) ) of >or = 1 : .
364
Also in the most cases of trisomy 21 and 18 and in triploidies a characteristic ratio of hcg/free beta-hcg and papp-a was discovered .
365
The estimated risk for trisomy 21 based on maternal age , fetal nt and maternal serum free beta-hcg and papp-a was 1 in 300 or greater in 5.1 % ( 362 of 6897 ) and 8 % ( 329 of 3840 ) of normal pregnancies , and in 78.9 % ( 15 of 19 ) and 88.5 % ( 23 of 26 ) of those with trisomy 21 .
366
The performance of screening using maternal age and serum-free beta-hcg and papp-a at 10 weeks of pregnancy was better than the double test ( alpha-fetoprotein and hcg with maternal age ) and similar to the triple test ( alpha-fetoprotein , unconjugated oestriol and hcg with maternal age ) at 15-22 weeks .
367
Fetal delta nuchal translucency ( nt ) , maternal serum papp-a and free beta-hcg were compared between pregnancies with sle ( n = 10 ) and without preexisting maternal disease ( n = 1140 ) .
368
Screening for trisomy 21 in twin pregnancies in the first trimester using free beta-hcg and papp-a , combined with fetal nuchal translucency thickness .
369
Inclusion of the nasal bone in the current first-trimester screening protocol along with nuchal translucency , free beta-hcg and papp-a can achieve high detection at a very low false-positive rate .
370
Serum samples were obtained from 67 pregnant women with twin pregnancies and maternal serum free beta-hcg and papp-a concentrations were compared with those of 4279 singleton controls between the 8th and 13th weeks of gestation .
371
In the control group there was a small but significant correlation of pigf with free beta-hcg ( r = +01024 ) and papp-a ( r = +02288 ) .
372
In all cases the fetal karyotype was determined by chorionic villus sampling ( cvs ) , which was carried out at the request of the parents after first-trimester screening for trisomy 21 by fetal nt and maternal serum free beta-hcg and papp-a .
373
In the preterm delivery group ( n = 159 ) , the median free beta-hcg ( 0944 mom ) and uterine artery mean pi ( 106 ) were not significantly different from normal but the median papp-a ( 0928 mom ) was significantly lower than normal .
374
Europium ( eu ) and samarium ( sm ) chelates were conjugated to two additional monoclonal antibodies acting as detection antibodies for papp-a and beta-hcg .
375
This was a multicenter study of screening for trisomy 21 by a combination of maternal age , fetal nt and maternal serum free beta-hcg and papp-a at 11-14 weeks of gestation , using the methodology developed by the fetal medicine foundation .
376
Risks for trisomy 21 and 18/13 were calculated together with serum pappa and free beta-hcg in all cases .
377
Results of maternal serum pregnancy-associated plasma protein a ( papp-a ) and beta-human chorionic gonadotrophin ( beta-hcg ) adjusted for gestational age were compared between rh-negative and rh-positive women with p < 0.05 considered significant .
378
In the trisomy group there were significant positive associations between total activin-a and papp-a ( 06071 ) and free beta-hcg ( 04255 ) .
379
We examined 54,722 singleton pregnancies with no chromosomal abnormality and with complete outcome data that had undergone screening for trisomy 21 by a combination of fetal nuchal translucency ( nt ) thickness , maternal serum free beta-human chorionic gonadotropin ( beta-hcg ) and pregnancy-associated plasma protein-a ( papp-a ) at 11 + 0 and 13 + 6 weeks' gestation .
380
Maternal age , crown-rump length ( crl ) ( restricted to a range from 45 - 84 mm or , equivalently , 11 + 1 - 14 + 0 weeks of gestation ) , nuchal translucency ( nt ) , as well as the maternal serum parameters papp-a ( pregnancy associated plasma protein a ) and free beta-hcg ( free human chorionic gonadotropin ) .
381
The medians +/- sd for delta nt , log ( 10 ) mom of papp-a and free beta-hcg +/- sd in pregnancies with sle and without maternal disease were - 0.18 +/- 0.29 versus - 0.18 +/- 0.33 , 0.005 +/- 0.32 versus 0.02 +/- 0.26 , and 0.22 +/- 0.19 versus - 0.014 +/- 0.28 , with a p value of 0.7 , 0.98 and 0.03 , respectively .
382
In screening for trisomy 21 by maternal age and serum free beta-hcg and papp-a the estimated detection rate was 65% for a false-positive rate of 5%. conclusions : .
383
In first-trimester biochemical screening for trisomy 21 it is essential to adjust the measured values of free beta-hcg and papp-a for maternal and pregnancy characteristics .
384
In a preliminary study we showed that while papp-a levels were lower and free beta-hcg levels were higher in trisomy 21 fetuses with an absent nasal bone , this difference was not statistically different .
385
The degree of deviation from normal in the levels of inhibin and activin is small in comparison with free beta-hcg and papp-a and they are therefore unlikely to be of value in improving the sensitivity of 90% for a 1% false-positive rate achieved by screening with fetal nuchal translucency and maternal serum free beta-hcg and papp-a .
386
Receiver operator characteristics ( roc ) curves showed that the highest sensitivity for detection , 71.2 per cent ( 95 per cent ci 547-876 per cent ) , was for depressed papp-a levels ; the combination of low serum papp-a levels , maternal age , and elevated free beta-hcg levels yielded a detection rate of 78.9 per cent ( 95 per cent ci 649-928 per cent ) of the affected pregnancies at 8-12 weeks' gestation .
387
Twin pregnancy showed significant increases in mom values of free beta-hcg ( by 187-fold ) and papp-a ( by 224-fold ) , with no significant changes in fetal nt mom values .
388
Maternal serum levels of free beta-hcg and papp-a in the first trimester of pregnancy are not associated with subsequent fetal growth retardation or preterm delivery .
389
In the netherlands , prenatal screening for trisomy 21 in the first trimester of pregnancy for singletons is conducted through a combined test based on maternal age , nuchal translucency measurement and maternal serum free beta-hcg and papp-a .
390
Comparison with eqa samples showed a 2% positive bias against the altm for free beta-hcg and a 21% positive bias for papp-a , which reduced to 11% when compared with the kryptor method mean .
391
The separation of affected and unaffected pregnancies in maternal serum pigf is small , and therefore it is unlikely that measurement of pigf would improve screening for these abnormalities provided by the combination of fetal nuchal translucency and maternal serum papp-a and free beta-hcg .
392
For a fixed false-positive rate of 5% the respective detection rates of screening for trisomy 21 by maternal age alone , maternal age and serum free beta-hcg and papp-a , maternal age and fetal nt , and by maternal age , fetal nt and maternal serum biochemistry were 30.5% , 59.8% , 79.3% and 90.2% , respectively .
393
The levels of plgf were compared in cases and controls , and were assessed for association with free beta-human chorionic gonadotropin ( beta-hcg ) and pregnancy-associated plasma protein-a ( papp-a ) .
394
There was a significant relation between low papp-a mom , low beta-hcg mom , increased risk estimate for ds and low birth weight and sga .
395
To evaluate whether repeat sampling and testing of free beta-hcg and papp-a during this period would result in an improved detection rate .
396
Diagnosis and prediction of parental origin of triploidies by fetal nuchal translucency and maternal serum free beta-hcg and papp-a at 11-14 weeks of gestation .
397
Placenta growth factor ( pigf ) , an angiogenic factor belonging to the vascular endothelial growth factor family , pregnancy-associated plasma protein a ( papp-a ) and free beta-human chorionic gonadotrophin ( beta-hcg ) were measured in maternal serum from 45 pregnancies with trisomy 21 , 45 with trisomy 18 and 493 normal controls at 10-13 completed weeks of gestation .
398
Normative values have been generated to allow conversion of nt , free beta-hcg and papp-a to their mom equivalents and correction factors have been determined to adjust for maternal and pregnancy characteristics for use in ethnic chinese women undergoing first-trimester screening for aneuploidy .
399
Based on 45 trisomy 18 cases , we confirm the values of alpha-fetoprotein ( afp ) ( median 061 mom ) , free beta-human chorionic gonadotrophin ( beta-hcg ) ( median 024 mom ) and of papp-a ( median 008 mom ) .
400
73.7 per cent for all three markers ; 69.1 per cent for papp-a and free beta-hcg ; 47.4 per cent for papp-a and afp ; 57.6 per cent for free beta-hcg and afp .
401
We have shown that gravidity and parity is associated with a small but progressive decrease in fetal nt and a small but progressive increase in free beta-hcg and papp-a .
402
20 had undergone nuchal translucency screening ( nt group ) and 20 had undergone serum screening ( papp-a and free beta-hcg ) ( ss group ) .
403
Application of an algorithm , which combines papp-a and f beta-hcg levels with material age , detected 66.6 per cent of ds pregnancies for a five per cent false positive rate .
404
To determine the value of serum screening for down's syndrome at 8-14 weeks of pregnancy using seven potential serum markers ( alpha-fetoprotein , unconjugated oestriol , total human chorionic gonadotrophin ( hcg ) , free alpha-hcg , free beta-hcg , pregnancy associated plasma protein a ( papp-a ) , and dimeric inhibin a ) .
405
The corresponding median pregnancy associated plasma protein ( papp-a ) was 0.30 and free beta-human chorionic gonadotropin ( beta-hcg ) 2.02 .
406
Higher median levels of free beta-hcg and papp-a in the first trimester of pregnancy in a chinese ethnic group .implication for first trimester combined screening for down's syndrome in the chinese population .
407
This study investigated the accuracy of down's syndrome screening during gestational weeks 10 to 13 using the combination of fetal nuchal translucency ( nt ) measurement with maternal serum concentrations of free beta-human chorionic gonadotropin ( beta-hcg ) and pregnancy-associated plasma protein-a ( papp-a ) .
408
To investigate the potential utility of first trimester screening for down syndrome using free beta-hcg , total hcg and papp-a .
409
To examine the effectiveness of first-trimester fetal trisomy 21 screening using a combination of maternal age , nuchal translucency thickness ( nt ) and maternal serum free beta-human chorionic gonadotropin ( beta-hcg ) and pregnancy-associated plasma protein-a ( papp-a ) levels in a predominantly chinese population in hong kong .
410
Maternal serum free beta-hcg and papp-a in patients with habitual abortion-influence on first-trimester screening for chromosomal abnormalities .
411
The geometric means of chromosomally normal twin pregnancies were 1.85 mom for free beta-hcg and 2.36 mom for papp-a .
412
In this study , we aim to measure the value of first-trimester maternal serum free beta-hcg and papp-a as predictors of homozygous alpha0-thalassemia-affected pregnancies .
413
Correlation with previously established pregnancy-associated plasma protein-a ( papp-a ) and free beta-human chorionic gonadotropin ( beta-hcg ) multiples of the median ( moms ) and nuchal translucency thickness ( nt ) mom were determined and used to model the performance of first trimester screening with adam12 in combination with other first trimester markers .
414
For other sex chromosomal anomalies ( 47xxx , xxy , xyy ) the median nt was increased ( 207 mom ) whilst papp-a was not significantly decreased ( 088 mom ) and free beta-hcg was not significantly different ( 107 mom ) from controls .
415
To derive a model and examine the performance of first-trimester screening for trisomy 18 by maternal age , fetal nuchal translucency ( nt ) thickness , and maternal serum free beta-human chorionic gonadotropin ( beta-hcg ) and pregnancy-associated plasma protein-a ( papp-a ) .
416
For free beta-hcg , the sd was reduced from 0.2675 to 0.2605 and for papp-a , it was reduced from 0.2545 to 0.2336 .
417
First-trimester biochemical screening for down syndrome with the use of papp-a , afp , and beta-hcg .
418
The distributions ( in multiples of the median ; mom ) of free beta-hcg and papp-a ( corrected for maternal weight ) and fetal nuchal translucency ( nt ) were determined in the trisomy 21 group and the controls .
419
Screening for trisomy 21 by fetal tricuspid regurgitation , nuchal translucency and maternal serum free beta-hcg and papp-a at 11 + 0 to 13 + 6 weeks .
420
Using time-resolved fluorometry , a simple one-step dual-label immunometric assay has been developed , which allows simultaneous determination of pregnancy-associated plasma protein a ( papp-a ) and free beta-subunit of human chorionic gonadotrophin ( beta-hcg ) in first-trimester maternal serum samples .
421
Based on these parameters we estimate that screening at 9-11 weeks with papp-a and free beta-hcg will yield a 64.6 per cent detection rate for a 5 per cent false-positive rate .
422
The correlation between free beta-hcg in sample 1 and sample 2 was 0.890 and that for papp-a was 0.827 .
423
The median +/- sd ( log ( 10 ) ) for delta-nt , multiple of medians ( mom ) papp-a and mom free beta-hcg ( corrected for maternal weight , smoking and ethnicity ) was - 0.17 +/- 0.62 , 1.10 +/- 0.28 , 1.1 +/- 0.28 and - 0.15 +/- 0.51 , 0.98 +/- 0.26 , 0.94 +/- 0.3 in pregnancies with and without a history of early vaginal bleeding , which were not significantly different .
424
Prediction of pregnancy complications by first-trimester maternal serum papp-a and free beta-hcg and with second-trimester uterine artery doppler .
425
The distribution of fetal nt , maternal serum free beta-hcg and papp-a in trisomy 21 fetuses with absent and present tricuspid regurgitation was examined .
426
Alpha-fetoprotein ( afp ) , human chorionic gonadotrophin ( free beta-hcg ) were used as markers during the first year of pregnancy .
427
The women underwent a nuchal translucency ultrasound measurement and a blood sampling for pregnancy-associated plasma protein a and free beta-hcg subunit ( free total chorionic gonadotropin subunit ) assay in the first trimester of pregnancy .
428
In the first step , a 0.5 mom cut-off for afp or for free beta-hcg resulted in detection of 37/45 trisomy 18 cases ( 82% ) with a 10% false-positive rate .
429
Patients with preexisting sle have increased maternal serum-free beta-hcg levels in the first-trimester .
430
Exclusion of patients with spotting from the vaginal bleeding group revealed significantly higher maternal serum free beta-hcg mom values ( median +/- sd ( log ( 10 ) ) ) compared to patients without bleeding , 1.29 +/- 0.27 versus 0.96 +/- 0.3 ( p = 0.011 ) .
431
Maternal serum concentration of free beta-hcg was significantly increased in women with pregnancies affected by homozygous alpha0-thalassemia than in controls ( p = 001 ) .
432
Modeled detection rates incorporating adam12 , free beta-hcg , and nt were 92% at 1% false positive rate ( 88% at 05% ) a combination of all four markers had a detection rate of 96.5% at a false positive rate of 1% ( 95% at 05% ) .
433
Free beta-hcg levels were increased in trisomy 21 but decreased in trisomy 18 , whereas alpha-fetoprotein was low in trisomy 21 , 18 and other chromosomal abnormalities .
434
Free beta-hcg was 12% higher in women of afro-caribbean origin , 9% lower in south asians , 8% higher in east asians , 2% higher in nulliparous women , 4% lower in smokers and 9% higher in those conceiving by ivf .
435
1.98 mom for free beta-hcg in 579 cases ; 0.79 mom for afp in 243 and 0.74 mom for ue3 in 226 .
436
Free beta-hcg and intact hcg concentrations were very high [> or = 2.5 multiples of the median ( mom ) ] in all cases .
437
First trimester free beta-hcg is significantly higher in pregnancies with a female fetus .
438
However , neither beta-hcg - nor plac4 mrnas show a significant difference between cases and controls .
439
Pregnancies affected by homozygous alpha0-thalassemia are associated with increased maternal serum free beta-hcg at 11-14 weeks of gestation .
440
For afp , levels in citrated plasma and edta plasma were also significantly reduced , whereas levels of free beta-hcg were not affected .
441
We carried out a multi-centre , interventional study in the unselected population of a single health authority in order to assess the performance of first trimester combined screening , followed by routine second trimester ultrasound examination and/or screening by maternal serum markers ( free beta-hcg and alpha-fetoprotein measurement or total hcg , alpha-fetoprotein and unconjugated estriol measurement ) when incidentally performed .
442
The values of free beta-hcg were not statistically different between the two groups .
443
Only free beta-hcg corrected multiples of the median ( mom ) values were statistically increased in rh-negative women ( p < 0009 ) .
444
Free beta-hcg mom was significantly reduced in the ivf fresh embryos subgroup ( 087 mom ) , but not in the other three subgroups .
445
We have found the median multiple of the median ( mom ) of maternal serum free beta-hcg to be significantly lower ( 0327 ) than normal , as was the level of afp ( 0600 ) .
446
Seventy-nine matched case-control sets of maternal serum samples ( each down syndrome case matched to 5 controls ) from 11 through 13 completed weeks of gestation were taken from the sample bank of the first and second trimester evaluation of risk consortium , a population-based study , and assayed for levels of free beta-hcg , total hcg , and inhibin a. distribution characteristics and correlations of the multiples of the median values were estimated in cases and controls .
447
Using this as part of a contingent-screening model to select an intermediate risk group of women for nt and free beta-hcg at 11-12 weeks would enable the detection of 92% of cases with a 1% false-positive rate at a cost of providing nt and free beta-hcg for 6% of women with 94% of women having completed screening by the 10th week of pregnancy .
448
At the 5th centile of the normal outcome group for free beta-hcg ( 041 mom ) the odds ratio for fetal loss before 24 weeks , at or above 24 weeks and at any gestation was 3.1 , 1.8 and 2.6 , respectively .
449
No marker showed significant correlation with any other or with maternal age , with the obvious exception of free beta-hcg subunit and total hcg .
450
To evaluate the performance and use of second-trimester multiple-marker maternal serum screening for trisomy 21 by women who had previously undergone first-trimester combined screening ( nuchal translucency , pregnancy-associated plasma protein a , and free beta-hcg ) , with disclosure of risk estimates .
451
First trimester maternal serum screening for down's syndrome : an evaluation of the dpc immulite 2000 free beta-hcg and pregnancy-associated plasma protein-a assays .
452
Low levels of free beta-hcg and increased nt were less consistently associated with adverse outcomes and high levels of free beta-hcg showed limited use as an indicator .
453
Normal 1.06 , 95 per cent ci 0.89-1.20 ) were lower and free beta-hcg subunit measurements ( 113 mom , 95 per cent ci 093-263 versus normal 091 , 95 per cent ci 079-103 ) were higher at statistically significant levels .
454
Serum free beta-hcg and alpha-fetoprotein levels may give additional information .
455
In general , for free beta-hcg , this should be by dividing the observed corrected mom by 2.023 .
456
Free beta-hcg was the only analyte that resulted in significantly higher values in art pregnancies ( 112 mom ) versus controls ( 099 mom ) .
457
Maternal age , serum pregnancy-associated plasma protein a and free beta-hcg and fetal nuchal translucency at 10 to 14 weeks' gestation ; integrated screen :
458
Similarly , agreement for free beta-hcg was linear with slopes between 0.99 and 1.09 .
459
The afp and free beta-hcg can be useful markers to detect down's syndrome and fetal abnormality .
460
0.95-1.37 ) for beta-hcg and 0.97 ( 95% ci : .
461
Second-trimester levels of pregnancy-associated plasma protein-a and free beta-hcg in pregnancies with trisomy 13 .
462
The median mom values for free beta-hcg were 1.00 mom for the controls , 2.05 mom for trisomy 21 and 0.38 mom for trisomy 18 .
463
However , free beta-hcg was significantly higher ( p = 000004 ) in the presence of a female fetus than in the presence of a male fetus .
464
When compared with the kryptor , the dpc free beta-hcg showed a significant concentration-related negative bias above concentrations of 50 iu/l in both unaffected and affected pregnancy samples .
465
Analyzing maternal serum beta-hcg and pregnancy-associated plasma protein a levels increases the accuracy of 1st trimester screening .
466
For a fixed false-positive rate of 5 % , the respective detection rates of screening for fetal down's syndrome by maternal age and serum free beta-hcg and paap-a , maternal age and fetal nt and by maternal age , fetal nt and maternal serum biochemistry were ( general gynaecologists' practices/prenatal centre ) 68.4/69.2 % , 42.1/65.4 % and 78.9/88.5 % , respectively .
467
The fetal aneuploidy screening database of general medical laboratory aml in antwerp was searched for 2mss tests between 1992 and 1999 ( alpha-fetoprotein , beta-human chorionic gonadotropin ( beta-hcg ) and unconjugated estriol , cut-off 1 : 300 ) and for 1mss tests between 1999 and 2003 ( free beta-hcg and pregnancy-associated plasma protein a , cut-off 1 : 85 ) .
468
Those with intermediate risks received second-trimester maternal serum alpha-fetoprotein , free beta-hcg , unconjugated estriol and inhibin-a .
469
The respective values for the 5th centile of free beta-hcg ( 041 mom ) were 1.18 and 1.08 and for the 95th centile of delta nt they were 0.91 and 0.77 , respectively .
470
Free beta-hcg was also elevated ( median mom 209 ) with 33% of cases above the 95th centile .
471
The median level of free beta-hcg was higher ( p = 00005 ) , and the median afp lower in female pregnancies .
472
In cases with down's syndrome , the median free beta-hcg mom was 1.703 for dpc and 1.698 by the kryptor , which was not significantly different .
473
Using a 1 in 250 cut-off risk , drs at each gestation in the second trimester for the afp+f beta-hcg combination were maximized at 14-17 weeks of gestation and were virtually identical at 63-65% for model 1 and model 2. a similar trend was observed for the afp+thcg combination , with an optimum gestational range of 15-18 weeks and drs of 66-68%. in the first trimester , using a 1 in 250 cut-off risk , drs were more variable with gestation for the prime marker combination of f beta-hcg+papp-a , varying from 73% at 8 weeks to 65% at 13 weeks with model 1 and from 75% to 66% with model 2. conclusion : .
474
Plac4 and beta-hcg mrna levels are not altered in the maternal circulation of pregnancies with trisomy 21 .
475
Alpha-fetoprotein , free beta-hcg or total hcg , unconjugated estriol and inhibin-a .
476
Pregnancy-associated plasma protein a , free beta-hcg , nuchal translucency , and risk of pregnancy loss .
477
P < 0.000001 ) and free beta-hcg ( p < 0000001 ) in trisomy 18 affected pregnancies when compared with the unaffected samples .
478
Free beta-hcg was found to be an independent predictor of gestational hypertension and pre-eclampsia .
479
After conversion to mom in the down's syndrome group , the dpc free beta-hcg assay showed a mom-related bias at higher mom values .
480
Adjustment for smoking is recommended in first-trimester prenatal screening for trisomy 18 and probably not warranted for down syndrome because of the cancelling effects of decreased free beta-hcg and increased nt .
481
The median free beta-hcg in multiples of the appropriate gestational median ( mom ) in the second-trimester samples was not significantly different from the controls ( 1.15 ( 95% ci 0827-1651 ) versus 1.00 ) .
482
An earlier episode of vaginal bleeding is associated with an increase in maternal serum free beta-hcg levels at first-trimester combined screening for down syndrome .
483
Mom values ( body weight-corrected ) of free beta-hcg were 25.2% higher in africans and 19.4% higher in orientals but 6.8% lower in other arabian and asian ( by 58% ) women as compared to saudi women ( p < 005 ; in each case ) .
484
For women who on examination were at 14 weeks of gestation or greater , or for women presenting as late bookers beyond 14 weeks , screening was performed in the same time frame using only maternal serum free beta-hcg and alpha-fetoprotein .
485
All patients had a first-trimester nuchal translucency scan , and those without cystic hygroma had a combined test ( nuchal translucency , pregnancy-associated plasma protein a , and free beta-hcg ) and returned at 15-18 weeks for a second-trimester quadruple screen ( serum alpha-fetoprotein , total hcg , unconjugated estriol , and inhibin-a ) .
486
To assess the effectiveness of free beta-hcg , pregnancy-associated plasma protein a , and nuchal translucency in a prospective first-trimester prenatal screening study for down syndrome and trisomy 18 .
487
0.93-1.25 ) for beta-hcg and 1.02 ( 95% ci : .
488
Median multiples of the median levels of free beta-hcg , total hcg , and inhibin a in cases were more elevated as gestation increased from 11 to 13 weeks , with univariate detection rates of 31% , 23% , and 29% , respectively , at a 5% false-positive rate .
489
Screening for trisomies 21 , 18 and 13 by maternal age , fetal nuchal translucency , fetal heart rate , free beta-hcg and pregnancy-associated plasma protein-a .
490
For maternal serum free beta-hcg levels are higher by 15% if the fetus is chromosomally normal and by 11% if the fetus has trisomy 21 .
491
Statistical modelling techniques suggest that this would be 58% compared with the expected 67% when combined with maternal age and free beta-hcg .
492
First-trimester screening for fetal aneuploidy using nuchal translucency ( nt ) , pregnancy-associated plasma protein a , free or total beta-hcg , and maternal age constitutes a very effective screening test for fetal down syndrome .
493
Combined measurement of fetal nuchal translucency , maternal serum free beta-hcg , and pregnancy-associated plasma protein a for first-trimester down's syndrome screening .
494
There was a significant increase in the mom of free beta-hcg in female fetuses .
495
Maternal serum free beta-hcg levels were lower in pregnancies complicated by pre-eclampsia than in normotensive ones .
496
We carried out a multicenter , interventional study in the unselected population of a single health authority in order to assess the performance of first-trimester combined screening , followed by routine second trimester ultrasound examination and/or screening by maternal serum markers ( free beta-hcg and alpha-fetoprotein measurement or total hcg , alpha-fetoprotein , and unconjugated estriol measurement ) when incidentally performed .