Table 11.9Fetal DNA

Author, year, country, EL, study designNo. of women analysed, inclusion/exclusion criteria, age, gestational age at testReference standard used, incidence of PEIndex test cut-offResultsComments and conclusion
Cotter (2004)859
Ireland, EL II, case–control study (nested and matched)
264 (88 cases and 176 controls)
IN: normotensive non- proteinuric women, male fetuses
EX: aneuploid fetuses 26.1 ± 5.9 years, 15.7 ± 3.6 weeks
BP ≥ 140/90 mmHg; Prot. ≥ 0.3 g/24 hours or 1+/2+ dipstick, Incidence n.r.fDNA Real-time PCR TaqMan SRY< 10 000 copies/ml< 50 000 >50 000SRY copies/ml
< 10 000: ST 94.32%, SP 32.39%, LR+ 1.39
< 50 000: ST 81.82%, SP 64.77%, LR+ 2.32
>50 000: ST 38.64%, SP 90.34%, LR+ 4.00
Increased fetal DNA is present in the maternal circulation in early pregnancy in women who subsequently develop pre-eclampsia and there appears to be a graded response between the quantity of fetal DNA and the risk of developing pre-eclampsia.
Leung (2001)860
Hong Kong, EL II, case–control study (nested and matched)
51 (18 cases and 33 controls), IN: singleton pregnancies, male fetuses
Age n.r.
11–22 weeks
DBP ≥ 90 mmHg 2x ≥ 4 hours apart or DBP ≥ 110 mmHg; Prot. ≥ 0.3 g/24 hours or 2+ dipstick 2x ≥ 4 hours apart, Incidence n.r.fDNA Real-time PCR TaqMan SRY ≥ 33.5 Geq/mlSRY
≥ 33.5 Geq/ml: ST 67%, SP 82%
(can’t calculate LRs)
Maternal plasma fetal DNA might be used as a marker for predicting pre-eclampsia.

From: 11, Screening for clinical problems

Cover of Antenatal Care
Antenatal Care: Routine Care for the Healthy Pregnant Woman.
NICE Clinical Guidelines, No. 62.
National Collaborating Centre for Women's and Children's Health (UK).
London: RCOG Press; 2008 Mar.
Copyright © 2008, National Collaborating Centre for Women’s and Children’s Health.

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