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    Obgyn Trisomy Wan-Githa Ayu Astarika

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    Obgyn Trisomy Wan-Githa Ayu Astarika

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    jurnal reading presentation

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    obgyn Trisomy Wan-githa Ayu Astarika

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    19 views15 pages

    Obgyn Trisomy Wan-Githa Ayu Astarika

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    githa
    jurnal reading presentation

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    Early first-trimester maternal

    serum placental growth factor in


    trisomy 21 pregnancies

    N. J. COWANS*, A. STAMATOPOULOU*, N. TØRRING† AND K. SPENCER*


    *PRENATAL SCREENING UNIT, DEPARTMENT OF CLINICAL BIOCHEMISTRY, KING
    GEORGE HOSPITAL, GOODMAYES, UK; †DEPARTMENT OF CLINICAL BIOCHEMISTRY,
    AARHUS UNIVERSITY HOSPITAL, AARHUS, DENMARK

    PRESENTER_GITHA AYU ASTARIKA


    Most common and
    Traditional second
    best for women
    trimester approach
    presenting late

    Screning for major


    Nucheal
    fetal chromosomal
    Translucency
    anomalies

    First trisemester Free-Beta-


    approach?? humanchoriogona
    drotropin (BhCG)

    Pregnancy –
    ascosiated plasma
    protein A (PAPPA)
    PLASENTAL GROWTH FACTOR (PlGF)

    VEGF family Role of PlGF Fetus chromosomal Trisomy 21??


    anomalies

    •Have similiar •Angiogenis •2 study reports •Unclear


    amino acid decrease of PlGF •Previous study
    levels on Trisomy shows increasing,
    13 and 18 decreasing and
    unchanged level
    Objective

     This study aims to test this hypothesis by


    examining levels of PlGF in maternal serum
    samples from control and trisomy 21 pregnancies
    drawn at 8+0 to 10+6 weeks’ gestation.
    PATIENTS & METHODS

    STUDY
    • Retrospective Case-Control
    DESIGN

    STUDY
    • November 2003-February 2009
    PERIOD

    • Department of Clinical Biochemistry


    INSTITUTION at Aarhus University Hospital, Skejby
    PATIENTS & METHODS

     COMPARATION

     GROUP 1 : 37 sample from case with known Trisomy 21

    (November 2003 – January 2009)

     GROUP 2 : 244 euploid control pregnancy

    (January 2009- February 2009)


    women with a confirmed
    using the FMF algorithm
    Draw blood between 8 + pregnancy diagnosis of
    as part of the Astraia
    0 and 10 + 6 weeks of trisomy 21 were offered
    Software database for
    pregnancies termination of
    risk of aneuploid
    pregnancy.

    stored at −80◦C and not


    Measure biochemically
    thawed until PlGF PlGF Analysis
    for PAPP A and NT
    analysis.

    sent to the Department


    of Clinical Biochemistry
    at Aarhus University Convert to Multiple of
    Hospital, Skejby for free- Median
    β-hCG and PAPP-A
    analysis
    PlGF Analysis
    Using a solid-phase, two-site fluoroimmunometric
    research assay on the 6000 DELFIA® Xpress
    random access platform (kit 4083-0010,
    PerkinElmer, Turku, Finland).

    PlGF analysis was carried out over 2 days with


    the kit calibrated at the beginning of the first
    day.

    The lower limit of detection was given as 7


    pg/mL by the kit’s manufacturers, however,
    we calculated it to be 3.2 pg/mL (mean of
    lowest calibrator + 3 SD of six replicates of
    this sample).

    Samples were analyzed blinded to


    clinical outcome.
    Statistical Analysis

    Mann whiitney test 


    Multiple regression for MoM continous variable
    PlGFdetermine influencing
    factor for PlGF Pearson Chi Square test 
    categorical variables

    Pearson,s product moment


    test corelation of log 10
    screening marker MoM
    RESULT
    Table 1 Maternal serum sample storage time and demographic data
    in trisomy 21 cases and unaffected controls

    Unaffected Trisomi 21
    (n = 244) (n = 37)

    Storage age (years) 0,96 (0,95-0,97) 2,52 (2,09-3,97)*

    Gestational age (days) 66,0 (61,0-70,0) 65,0 (60,3-68,8)

    Maternal age (years) 30,0 (28,0-33,0) 37,0 (30,8-40,0)*

    Maternal Age (kg) 66,8 (60,0-76,5) 65,0 (57,0-71,5)

    Smoker 7,4 2,7

    All mothers were Caucasian, information on parity and IVF was not available at the time of the data analysis.
    Maternal age and sample storage time were significantly higher in the trisomy 21 cases compared with the
    unaffected controls
    RESULT
    Table 2 Maternal serum placental growth factor levels in unaffected controls and trisomy 21 pregnancies
    at each completed week of gestation and at all weeks

    GA(weeks) Unaffected Trisomi 21 P*

    n PIGF (pg/mL) n PIGF (pg/mL)

    8 77 9,1 (7,1-12,5) 12 15,9 (11,9-17,7) <0,0001

    9 99 10,6 (8,1-13,0) 18 13,4 (11,4-17,0) <0,01

    10 68 12,8 (10,5-17,2) 7 15,0 (10,3-16,3) 0,92

    8-10 244 10,8 (8,0-13,7) 37 14,2 (11,1-17,2) <0,0001

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