{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T18:18:17Z","timestamp":1773944297172,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2002,3,12]],"date-time":"2002-03-12T00:00:00Z","timestamp":1015891200000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2002,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the performance of the double marker test [free \u03b2\u2010human chorionic gonadotrophin (\u03b2\u2010hCG) and alpha\u2010fetoprotein (AFP)] as a screening test for Down syndrome in pregnant patients who had a prior renal transplant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A retrospective study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>The Fetal Medicine Unit, Royal Free Hospital, London, UK.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Detailed records of 14 post\u2010renal transplant pregnancies were obtained from the Renal Unit of our hospital where the patients were followed up. The serum concentrations of urea, creatinine, free \u03b2\u2010hCG and AFP at the time of the double marker test were recorded, with a cut\u2010off point of 1:250 for the double marker test. A control group of 14 normal pregnancies matched for age, parity and gestational age was used. The Mann\u2010Whitney <jats:italic>U<\/jats:italic>\u2010test and <jats:italic>t<\/jats:italic>\u2010tests of unequal variance were applied to compare parameters of the study and the control groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two patients in each group were high risk for Down syndrome and amniocentesis revealed normal karyotype. No babies with Down syndrome were delivered in either group. Regression analysis showed significant correlation between free \u03b2\u2010hCG and urea concentrations (<jats:italic>p<\/jats:italic>&lt;0.001) and free \u03b2\u2010hCG and creatinine concentrations (<jats:italic>p<\/jats:italic>&lt;0.001), but not for AFP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The present study demonstrates that residual renal function alterations persisting after renal transplantation can affect the levels of free \u03b2\u2010hCG and AFP, thus resulting in false\u2010positive screening for Down syndrome. First trimester nuchal translucency (NT) measurement in combination with second trimester ultrasonographic markers can be used in these patients, or alternatively the free \u03b2\u2010hCG levels should be corrected according to the serum creatinine levels. 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