The Predictive Value of Quadruple Tests in the Second Trimester of Pregnancy in Identifying Pregnancy Complications

Author(s):

Maryam Nakhaee Moghadam, Hossein Ali Jahantigh, Esmail Azimi, Marzie Davoodi and Khadije rezaie Keikhaie*

Introduction: Four tests are performed on the 20th to 15th week of gestation . These tests include Triple Markers and Inhibin A Markers. Research has shown that abnormal levels of quadruple markers are useful in predicting side effects of pregnancy, and several studies have shown that there is a significant relationship between abnormal levels of four tests and preterm delivery, preeclampsia, pregnancy pressure, intrauterine growth restriction, and premature rupture of fetal curves. There are few previously published large studies that evaluated combination of quad screen markers,the aim of this study was to predict the predictive value of quadruple tests in the second trimester of pregnancy in the diagnosis of complications, especially the prediction of fetal death and abortion at birth. Method: This is a longitudinal study. All pregnant women in their second trimester who referred to Zabol city labaratory in 1995 and 1996 for Quad Marker testing were included. The exclusion criteria were: mothers over 35 years of age, mothers with a history of preterm labor, gestational hypertention and Down syndrome. Results: 240 pregnant women participated in this study. 29.2% of them were in the age group of 15 to 25 years old and 41.3% were in the age group of 31 to 35 years old. The results showed that only the surface area below the UE3 curve is statistically significant (AUC=0.144, p=0.007). The best UE3 value for detecting fetal death with a sensitivity of 100% and a 8% attribute equals 0.265 and the best AFP value for diagnosis of abortion with a sensitivity of 86% and 78% is 1,765. Discussion: In our study, although the underlying curve for Inhibin was higher than other markers, but the overlap between the confidence intervals for the surface under the curve of the three markers of Inhibin, Alfus, Protein and HCG indicated no significant difference in the level below the curve of the three markers. In a study by Duric et al., which was done by cohort method, 2384 pregnant women were evaluated in Croatia. The results of this study indicate that the increase in AFP was significantly associated with intrauterine growth retardation and spontaneous abortion, and the increase in HCG levels in the second trimester of pregnancy was associated with preterm delivery and intrauterine fetal death, as well as a decrease in the serum levels of 3 U.S. Mother in the second trimester of pregnancy is associated with preterm labor and restriction of uterine infertility.