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Second Trimester Screening

Down syndrome incidence 1 in 800
13% of all pregnant females are... over the age of 35
% of DS cases born to AMA patients 25-30
AFP is made where? fetal yolk sac and fetal liver
AFP peaks during what weeks gestation 12-14
Factors that influence MSAFP values 1. Gestational age 2. number 3. maternal age 4. maternal race 5. maternal wt 6. IDDM
Causes of ELEVATED MSaFP 1. Normal variant 2. Underestimation of gestational age 3. Multiples 4. Overest. of maternal wt 5. Poor placental function 6. ONTD 7. VWD 8. Renal Anomalies 9. Oligohydramnios 10. Congenital skin DOs 11. Bleeding 12. IUFD 13. Maternal DOs
hCG high in DS and best marker for DS
uE3 Fetoplacental hormone which helps stimulate the endometrium and augment uterine blood flow.
uE3 levels in DS are 25-30% lower
uE3 is the best marker for... bad dates and trisomy 18
DIA is a glycoprotein of placental origin similar to hCG that is twice as high in DS pregnancies
Causes of LOW MSAFP 1. Overestimation of dates 2. Underestimation of maternal weight 3. Normal variant 4. IUFD 5. IDDM 6. SGA 7. DS or other aneuploidy
Advantages of MSAFP screening 1. General for all 2. NTD 3. VWD 4. Fetal distress or demise 5. Multiparity 6. Trisomy 21 or 18 7. Nephrosis
Racial differences in AFP African Americans and IDDM Women have higher MSAFP levels
Created by: KChatham