The differences of mid-trimester triple marker levels according to the occurrence time and severity of preeclampsia

Seo, Yong Soo; Shin, Jung Hwan; Oh, Sun Ok; Hong, Yu Kyung; Shin, Jong Seoung; Park, Eun Ju; Park, Chul Hong; Park, Won Il; Lee, Jin Yong; Hong, Seo Yoo

Abstract

OBJECTIVE
To evaluate the differences of mid-trimester triple marker levels in patients with mild versus severe and early versus late onset preeclampsia.
METHODS
From January 2000 to December 2004, a retrospective study of 65 women with preeclampsia for whom mid-trimester triple test data were available was made. None of these patients had diabetes, other medical disorders, multiple pregnancy, abnormal karyotype and malformations. Preeclampsia patients were grouped to "early onset" [<32 weeks of gestation (wks), n=17] and "late onset" (n=48), and also "mild" (who had delivered with no symptoms and lab findings of severe preeclampsia at term spontaneous labor or elective cesarean delivery, n=31) and "severe" (n=34). The levels of mid-trimester maternal serum alpha-fetoprotein (MSAFP), human chorionic gonadotropin (hCG) and unconjugate estriol (MSuE3) in patients with early and late onset, mild and severe were compared.
RESULTS
The each groups of comparison did not differ significantly with regard to age, weight, parity. The mean MSuE3 [0.92+/-0.09 (MoM+/-SE)] in patients with early onset was significantly lower than in patients with late onset preeclampsia (1.24 MoM, SE 0.07). In the comparison according to severity, the mean MSuE3 was significantly lower (0.98 MoM, SE 0.06 vs 1.28 MoM, SE 0.10, p=0.016) and the mean hCG was significantly higher (1.46 MoM, SE 0.12 vs 1.12 MoM, SE 0.07, p=0.015) in patients with severe preeclampsia than in those had mild preeclampsia symptoms at term delivery.
CONCLUSION
Lower levels of mid-trimester MSuE3 and higher levels of hCG were associated with the severe preeclampsia rather than mild. Especially, lower levels of mid-trimester MSuE3 was also associated with early onset preeclampsia.