Department of Obstetrics and Gynecology, Haseki Training and Research Hospital, Istanbul, Turkey.
Department of Obstetrics and Gynecology, Memorial Atasehir Hospital, Istanbul, Turkey.
J Obstet Gynaecol Res. 2022 May;48(5):1091-1098. doi: 10.1111/jog.15188. Epub 2022 Feb 17.
Reliable aneuploidy risk estimation in first trimester is prominently interconnected with accurate assessment of maternal serum biomarkers. Some maternal factors like insulin-dependent diabetes, weight, and rhesus status are known to alter levels of these biomarkers. Adjustment of biomarker values for specific factor is crucial to avoid excessive invasive procedures or missed diagnoses. We aimed to investigate the effects of noncavity distorting intramural uterine fibroids on first trimester aneuploidy screening test maternal serum biomarkers.
Pregnant women who underwent first trimester aneuploidy screening test in a single tertiary center between 2011 and 2020 were retrospectively assessed. One hundred ninety-eight women were found to have at least one noncavity distorting intramural uterine leiomyoma (Figo type 3-6) of at least 2 cm diameter and remaining women were assigned as controls. First trimester aneuploidy screening test parameters were compared.
Pregnancy associated plasma protein-A (PAPP-A) MoMs were found significantly lower in leiomyoma group in comparison to control group (1.19 ± 0.60 MoM vs. 1.40 ± 0.73 MoM, p = 0.002). PAPP-A MoMs in women with leiomyomas larger than 5.5 cm were significantly lower in comparison to both control group and women with ≤5.5 cm leiomyomas (0.82 ± 0.376 vs. 1.40 ± 0.73, p < 0.001; 0.82 ± 0.376 vs. 1.33 ± 0.61 p < 0.001, respectively). PAPP-A MoM and size of leiomyoma were found inversely correlated when fibroid size exceeds 5.5 cm (r = -0.467, p < 0.001).
Noncavity distorting intramural uterine leiomyomas >5.5 cm are associated with low first trimester PAPP-A MoMs (<0.5). PAPP-A concentrations are inversely correlated with fibroid size in women with >5.5 cm intramural uterine leiomyomas. Fibroids ≤5.5 cm are not associated with alterations in first trimester aneuploidy screening test parameters.
可靠的早孕期非整倍体风险评估与母体血清生物标志物的准确评估密切相关。一些母体因素，如胰岛素依赖型糖尿病、体重和 Rh 状态，已知会改变这些生物标志物的水平。为了避免过度的侵入性程序或漏诊，对特定因素的生物标志物值进行调整至关重要。我们旨在研究非腔室扭曲的子宫壁内肌瘤对早孕期非整倍体筛查试验母体血清生物标志物的影响。
回顾性评估了 2011 年至 2020 年期间在一家单中心进行早孕期非整倍体筛查试验的孕妇。发现 198 名孕妇至少有一个直径至少为 2 厘米的非腔室扭曲的子宫壁内平滑肌瘤（FIGO 类型 3-6），其余孕妇作为对照组。比较早孕期非整倍体筛查试验参数。
与对照组相比，肌瘤组妊娠相关血浆蛋白-A（PAPP-A）MoM 明显降低（1.19±0.60 MoM 与 1.40±0.73 MoM，p=0.002）。肌瘤大于 5.5 厘米的妇女的 PAPP-A MoM 明显低于对照组和肌瘤≤5.5 厘米的妇女（0.82±0.376 与 1.40±0.73，p<0.001；0.82±0.376 与 1.33±0.61，p<0.001）。当肌瘤大小超过 5.5 厘米时，PAPP-A MoM 与肌瘤大小呈负相关（r=-0.467，p<0.001）。
5.5 厘米的非腔室扭曲的子宫壁内平滑肌瘤与早孕期 PAPP-A MoM 降低（<0.5）有关。在>5.5 厘米的子宫壁内平滑肌瘤妇女中，PAPP-A 浓度与肌瘤大小呈负相关。≤5.5 厘米的肌瘤与早孕期非整倍体筛查试验参数的改变无关。
