The New Indian Journal of OBGYN. Epub Ahead of Print

Evaluation of first trimester serum double marker test in prediction of fetal growth restriction

Amrita Chaurasia, Shalini Singh, Kumari Shweta

ABSTRACT

Objectives: To evaluate the clinical utility of the first trimester serum double marker test in their ability to predict subsequent delivery of a fetal growth restriction (FGR) infant. Methods: The association between first trimester double marker test and the incidence of FGR were assessed by comparing the relative incidence at their MoM cut-offs and their sensitivity, specificity were calculated. Results: The FGR group constituted 35 FGR pregnancy and non FGR case constituted 50 normal pregnancy. The mean level of β-hCG was reduced in FGR group (i.e.0.94 ±0.70 MoM Vs 1.49 ±0. 75 MoM; P value < 0.05) but its sensitivity for prediction of future FGR was found to be 48 % only. The mean level for serum PAPP-A was significantly reduced in FGR group of patients (i.e.0.76 ± 0.45 Vs 1.16 ± 0.53; p value = 0.0005) with the sensitivity for prediction of FGR of 54.3 %. With serum PAPP-A level, a weak positive relationship was found with birth weight the association of which was statistically significant. Conclusions: Low levels of maternal serum PAPP-A and serum free β-hCG are associated, in the absence of an abnormal karyotype, with an increased risk for subsequent delivery of an FGR infant.