Shenhav Simon, Gemer Ofer, Sassoon Essie, Volodarsky Michael, Peled Ronit, Segal Shmuel
Department of Obstetrics and Gynecology, Barzilai Medical Center, The Faculty of Health Sciences, Ben-Gurion University of the Negev, Ashkelon, Israel.
Prenat Diagn. 2002 Jul;22(7):579-82. doi: 10.1002/pd.365.
To study whether the degree of elevation of mid-trimester triple test markers differs in patients with early versus late onset severe pre-eclampsia.
A retrospective study of the medical records of 102 patients with severe pre-eclampsia for whom mid-trimester triple test result data were available was made. None of these patients had fetuses with abnormal karyotype nor delivered infants with malformations. Pre-eclampsia was defined as early onset when it presented before 32 weeks' gestation. The levels of mid-trimester maternal serum alpha-fetoprotein (MSAFP), human chorionic gonadotrophin (hCG) and unconjugated oestriol (MSuE(3)) in patients with early and late onset severe pre-eclampsia were compared.
Twenty-five patients had early onset and 77 patients had late onset severe pre-eclampsia. The two groups did not differ significantly with regard to age, weight, parity and severity of pre-eclampsia. The mean MSAFP in patients with early onset was significantly higher than in patients with late onset severe pre-eclampsia (1.46 MoM, SE 0.12 versus 1.16 MoM, SE 0.05; p=0.01). The mean hCG in the early onset group was also significantly higher than in the late onset group (1.71 MoM, SE 0.18 versus 1.21 MoM, SE 0.07; p=0.03). Mean MSuE(3) levels in patients with early onset were significantly lower than in patients with late onset severe pre-eclampsia (0.83 MoM, SE 0.05 versus 1.02 MoM, SE 0.03; p=0.04).
Higher MSAFP and hCG, and lower MSuE(3), may be more significant markers of early rather than late onset severe pre-eclampsia.
研究孕中期三联试验标志物升高程度在早发型与晚发型重度子痫前期患者中是否存在差异。
对102例有孕中期三联试验结果数据的重度子痫前期患者的病历进行回顾性研究。这些患者均无胎儿染色体异常，所分娩婴儿也无畸形。子痫前期在妊娠32周前出现则定义为早发型。比较早发型和晚发型重度子痫前期患者孕中期母血清甲胎蛋白（MSAFP）、人绒毛膜促性腺激素（hCG）和非结合雌三醇（MSuE(3)）水平。
25例为早发型，77例为晚发型重度子痫前期。两组在年龄、体重、产次和子痫前期严重程度方面无显著差异。早发型患者的平均MSAFP显著高于晚发型重度子痫前期患者（1.46倍中位数倍数，标准误0.12，对比1.16倍中位数倍数，标准误0.05；p = 0.01）。早发型组的平均hCG也显著高于晚发型组（1.71倍中位数倍数，标准误0.18，对比1.21倍中位数倍数，标准误0.07；p = 0.03）。早发型患者的平均MSuE(3)水平显著低于晚发型重度子痫前期患者（0.83倍中位数倍数，标准误0.05，对比1.02倍中位数倍数，标准误0.03；p = 0.04）。
较高的MSAFP和hCG以及较低的MSuE(3)，可能是早发型而非晚发型重度子痫前期更显著的标志物。
