Down Sendromu Taramasında Kullanılan Biyokimyasal Belirteçlerin Olumsuz Gebelik Sonuçlarını Öngörmede Yeri

Abstract

Down syndrome is the most common form of non-fatal trisomy. Our aim in this study is to investigate the relationship between certain major adverse pregnancy outcomes including pregnancy hypertension, placenta related complications, preterm rupture of membranes, diabetic complications of pregnancy and preterm delivery and the first and second trimester Down syndrome screening markers used in maternal serum screening tests. Patients whose Down syndrome screening tests within the scope of routine pregnancy follow-up and delivery performed at Hacettepe University Faculty of Medicine, Department of Obstetrics and Gynecology Outpatient Clinic, between 1 January 2002 and 31 December 2012 were enrolled. 8394 patients who met the criteria were included. 2804 of the patients (33.4%) had first trimester, 5590 (66.6%) had second trimester Down syndrome screening test. Mean age of the patients who underwent first-trimester screening test for Down syndrome was 30.51 ± 4.94, mean number of pregnancies was 2.06 ± 1.31, gestational weeks at an average of 37.81 ± 2.12 weeks and mean birth weight was 3198.61 ± 570, 64 g, while in the second trimester Down syndrome screening test group the mean age of the patients was 29.24 ± 5.07, mean number of pregnancies was 2.22 ± 1.28, gestational weeks at an average of 38.04 ± 10.15 weeks and mean birth weight was 3172,40 ± 578.45 g. Preterm birth was identified as the most common complication both in the first trimester (10.3%) and second trimester screening group (12.5%). The study concluded that there is a relationship between serum markers and adverse pregnancy outcomes, however the low levels of sensitivity and specificity of these markers made us to conclude that routine screening of adverse pregnancy outcomes with serum markers is not advisable. Key Words: maternal serum marker, adverse pregnancy outcome, pregnancy, Down syndrome screening, trisomy 21