Early vaginal bleeding and first-trimester markers for Down syndrome

Prenat Diagn. 2003 Jun;23(6):470-3. doi: 10.1002/pd.611.

Abstract

Objectives: To assess the effect of early vaginal bleeding on first-trimester markers for Down syndrome.

Methods: A retrospective study was conducted on 2330 normal singleton fetuses who underwent first-trimester combined screening for Down syndrome based on ultrasound and maternal serum markers. 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.

Results: 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. The false-positive rate was 2.4% and 3.6% (p = 0.33).

Conclusions: 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. However, this phenomenon is unlikely to significantly affect the false-positive rate of the test.

MeSH terms

  • Adolescent
  • Adult
  • Biomarkers / blood
  • Chorionic Gonadotropin, beta Subunit, Human / blood
  • Chorionic Villi Sampling
  • Down Syndrome / blood
  • Down Syndrome / diagnosis*
  • Down Syndrome / prevention & control
  • Endopeptidases / blood
  • False Positive Reactions
  • Female
  • Humans
  • Mass Screening / methods
  • Maternal Age
  • Middle Aged
  • Neck / abnormalities
  • Neck / diagnostic imaging
  • Pregnancy / blood
  • Pregnancy Proteins / blood
  • Pregnancy Trimester, First
  • Pregnancy, High-Risk
  • Pregnancy-Associated Plasma Protein-A*
  • Prenatal Diagnosis / methods*
  • Retrospective Studies
  • Ultrasonography, Prenatal
  • Uterine Hemorrhage* / blood

Substances

  • Biomarkers
  • Chorionic Gonadotropin, beta Subunit, Human
  • Pregnancy Proteins
  • Endopeptidases
  • PAPPA2 protein, human
  • Pregnancy-Associated Plasma Protein-A