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First- and Second-Trimester Maternal Serum Markers for Aneuploidy and Adverse Obstetric Outcomes

Dugoff, Lorraine MD

doi: 10.1097/AOG.0b013e3181da93da
Current Commentary

Maternal serum levels of the first- and second-trimester markers for aneuploidy have been shown to be associated with adverse obstetric outcomes in the absence of aneuploidy or neural-tube defects. The likelihood of an adverse obstetric outcome increases as the values of the marker become more extreme, and as the number of abnormal markers increases. Although many of the associations between maternal serum markers for aneuploidy and adverse obstetric outcomes are statistically significant, the sensitivity and positive predictive values for the individual outcomes are too low for them to be clinically useful as screening tests. Currently in the United States there is not a uniformly accepted practice for the care of women with abnormal maternal serum markers regarding risk of future obstetric complications. There are no randomized trials assessing any type of intervention or treatment for patients with abnormal serum markers. Various strategies to manage patients with unexplained abnormal serum markers have been proposed. This article reviews the relationships between these markers and adverse obstetric outcomes. In addition, potential management strategies and future areas of research are discussed.

Abnormal levels of first- and second-trimester maternal serum markers for aneuploidy are associated with adverse obstetric outcomes in the absence of aneuploidy or neural tube defects.

Corresponding author: Lorraine Dugoff, MD, University of Colorado Denver School of Medicine, Department of Obstetrics and Gynecology, Mail Stop B198-5, Academic Office 1, 12631 East 17th Avenue, Room 4001, Aurora, CO 80045; e-mail: Lorraine.Dugoff@ucdenver.edu.

Disclaimer: The practice of medicine continues to evolve and individual circumstances will vary. This opinion reflects information available at the time of its acceptance for publication and is not designed nor intended to establish an exclusive standard of perinatal care. This publication is not expected to reflect the opinions of all members of the Society for Maternal–Fetal Medicine.

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2010 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.