{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T20:31:02Z","timestamp":1722457862752},"reference-count":22,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2007,2,8]],"date-time":"2007-02-08T00:00:00Z","timestamp":1170892800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2007,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To examine the effect of early vaginal bleeding on first\u2010trimester screening markers for Down syndrome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective study was conducted on 1755 normal singleton fetuses that underwent first\u2010trimester combined screening for Down syndrome on the basis of ultrasound and maternal serum markers. Fetal \u03b4\u2010nuchal translucency (NT), maternal serum pregnancy\u2010associated plasma protein A (PAPP\u2010A) and free \u03b2\u2010hCG were compared between pregnancies with (<jats:italic>n<\/jats:italic> = 252) and without (<jats:italic>n<\/jats:italic> = 1503) an episode of vaginal bleeding. Subgroup analysis for the intensity of bleeding (spotting <jats:italic>n<\/jats:italic> = 191; light <jats:italic>n<\/jats:italic> = 32; heavy <jats:italic>n<\/jats:italic> = 29) was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median \u00b1 SD (log<jats:sub>10<\/jats:sub>) for \u03b4\u2010NT, multiple of medians (MoM) PAPP\u2010A and MoM free \u03b2\u2010hCG (corrected for maternal weight, smoking and ethnicity) was \u2212 0.17 \u00b1 0.62, 1.10 \u00b1 0.28, 1.1 \u00b1 0.28 and \u2212 0.15 \u00b1 0.51, 0.98 \u00b1 0.26, 0.94 \u00b1 0.3 in pregnancies with and without a history of early vaginal bleeding, which were not significantly different. Exclusion of patients with spotting from the vaginal bleeding group revealed significantly higher maternal serum free \u03b2\u2010hCG MoM values (median \u00b1 SD (log<jats:sub>10<\/jats:sub>)) compared to patients without bleeding, 1.29 \u00b1 0.27 <jats:italic>vs<\/jats:italic> 0.96 \u00b1 0.3(<jats:italic>p<\/jats:italic> = 0.011). Screen\u2010positive (cut off of 1:350) rate after combined first\u2010trimester screening was 28.1% in patients with light vaginal bleeding and 8.4% in patients without bleeding (<jats:italic>p<\/jats:italic> = 0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Light vaginal bleeding before first\u2010trimester combined screening for Down syndrome leads to a higher screen\u2010positive rate after combined first trimester screening, without a significant difference in serum levels of the screening markers. Copyright \u00a9 2007 John Wiley &amp; Sons, Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pd.1662","type":"journal-article","created":{"date-parts":[[2007,2,8]],"date-time":"2007-02-08T10:13:47Z","timestamp":1170929627000},"page":"312-316","source":"Crossref","is-referenced-by-count":5,"title":["Does vaginal bleeding influence first\u2010trimester markers for Down syndrome?"],"prefix":"10.1002","volume":"27","author":[{"given":"J.","family":"Heinig","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Steinhard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Schmitz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. 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