Correlation of prenatal screening indicators of the I trimester with the risk of pregnancy complications

• Elena V. Kudryavtseva
• Vladislav V. Kovalev
• Igor I. Baranov
• Kirill S. Vshivtsev
• Eduard V. Arebyev
• Natalya N. Bayazitova

Abstract

Aim. Evaluation of the relationship between biochemical and ultrasound parameters of the prenatal diagnostics complex (PDC) of the I trimester and non-invasive prenatal screening (NIPS) with the risk of pregnancy complications from the group of great obstetrical syndromes.

Material and methods. A retrospective cohort study included I trimester screening data for 391 women between 2017 and 2019 years. The main group (n=279) consisted of patients with pregnancy complications. The control group included women with a favorable pregnancy outcome (n=112). The following indicators were analyzed: PAPP-A and β-hCG levels, nuchal translucency (NT) and fetal fraction (FF) level at 11-13.6 weeks of pregnancy; NIPS was performed in 64 patients of the main group and 56 patients of the control group at 12-14 weeks of pregnancy; in addition, the analysis of obstetric history data and anthropometric indicators of patients was performed.

Results. Significant differences were found in obstetric anamnesis and anthropometric indicators; among biochemical parameters, reliable values for the average level of PAPP-A MoM between the main and control groups (p<0.01), high probability of adverse outcome when PAPP-A <0.3 MoM; a value of PAPP-A >1.5 MoM is a favorable prognostic sign. The value of NT was significant when comparing the control group and 1D subgroup (patients with intrauterine fetal death) (p<0.05). The level of FF in the main group was reduced compared to the control group (p=0.04).

Conclusions. Among the studied indicators, the PAPP-A level is the most important. An increase in NT in the absence of chromosomal abnormalities (CA) in the fetus is associated with the risk of intrauterine fetal death, even in the uncomplicated course of pregnancy. When performing NIPS, a lower level of fetal fraction is determined in patients with subsequent complicated gestation, but this parameter requires further study.

Keywords:prenatal screening, pre-eclampsia, great obstetrical syndromes, I trimester combined screening, noninvasive prenatal testing, fetal fraction

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