The relationship between unexplained elevated serum markers in triple test, uterine artery doppler measurements and adverse pregnancy outcome

Objective: To investigate the relationship between adverse pregnancy outcomes and unexplained elevations of second trimester maternal serum Human Chorionic Gonadotropin (hCG), Alpha Fetoprotein (AFP) levels and uterine artery Doppler measurements. Methods: A total of 144 women between 16-20 weeks of gestation that applied to our clinic for triple test were enrolled into the study. Study group consisted of 84 pregnant women with hCG and/or AFP levels ≥ 2 MoM. Control group comprised of 60 pregnant women with hCG and AFP levels 2 MoM. Study group was further subdivided into 3 subgroups: Subgroup I; only AFP ≥ 2 MoM (n=30), subgroup II; only hCG ≥ 2 MoM (n=64) and subgroup III; both AFP and hCG ≥ 2 MoM (n=10). Result: Operative delivery rate (p=0.0017), overall complication rate (p=0.0002), bilateral early diastolic notch presence rate (p=0.015) were high and mean birth weight was low (p=0.045) in the study group. In subgroup I patients, low birth weight [LBW] (p=0.0008), preterm delivery (p=0.0001), preeclampsia (p=0.003) and preterm premature rupture of membranes [PPROM] (p=0.012) rates were high. In subgroup II patients, only small for gestational age baby [SGA] (p=0.016) rate was high. In subgroup III patients LBW (p=0.009), preterm delivery (p=0.0001) and PPROM (p=0.01) rates were high. According to Doppler velocimetry studies, bilateral early diastolic notch presence rate was high (p= 0.015) in the study group. Conclusion: Patients with high AFP levels and bilateral uterine artery diastolic notch presence, are candidates for pregnancy complications and these groups of patients should be followed up more intensively.