INFORMATIVE VALUE OF FIRST-TRIMESTER PRENATAL SCREENING DURING COMPLICATED PREGNANCY
Objective. To estimate the informative value of a program for the prenatal diagnosis of Down and Edwards syndromes in the first trimester in patients with complicated pregnancy during hormonal therapy. Subjects and methods. Examinations were made at 9-12 weeks’ gestation in 505 pregnant women receiving hormonal therapy for threatening miscarriage and in 78 women with physiological pregnancy, by using noninvasive studies, such as ultrasonography, biochemical screening, fetal abnormality risk assessment software (a computer analysis), and invasive ones, such as transabdominal choriocentesis or transcervical chorion biopsy for embryonic karyotyping. The data obtained were statistically processed using an Excell program. Results. Abnormal values were found in 41.4-51.8% of the study group and in 46.1% of the control one. At the same time, there were no statistically significant differences in these values depending on what drug the study group women were taking. A risk group comprised 7.0 and 3.8% of the women, respectively. The major criterion for making up a risk group was an increase in the embryonic collar space. Chromosomal abnormality corresponding to Down syndrome was diagnosed only in one (0.2%) case in the study group. Conclusion. The results of the study suggest that complicated pregnancy and its related use of hormone drugs, as shown by noninvasive screening, increase a risk for a baby to be born with a chromosomal abnormality, as evidenced by computer analysis, due to the increased embryonic collar space. However, invasive prenatal diagnosis has shown that the rate of karyotype abnormalities in the fetuses from these women does not exceed the population values. Thus, hormonal therapy for complicated pregnancy does not affect indications for invasive prenatal diagnosis.