{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T19:47:29Z","timestamp":1791229649710,"version":"4.1.0"},"reference-count":32,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2006,9,4]],"date-time":"2006-09-04T00:00:00Z","timestamp":1157328000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2006,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To examine the clinical utility of the first\u2010trimester markers of aneuploidy in their ability to predict future fetal loss.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We examined 54 722 singleton pregnancies with no chromosomal abnormality and with complete outcome data that had undergone screening for trisomy 21 by a combination of fetal nuchal translucency (NT) thickness, maternal serum free \u03b2\u2010human chorionic gonadotropin (\u03b2\u2010hCG) and pregnancy\u2010associated plasma protein\u2010A (PAPP\u2010A) at 11 + 0 and 13 + 6 weeks' gestation. The biochemical markers were converted to multiples of the expected normal median for a pregnancy of the same gestation (MoM) and the measurements of fetal NT were expressed as the difference (delta) from the normal median NT for crown\u2013rump length (CRL). The association between free \u03b2\u2010hCG, PAPP\u2010A and delta NT and the incidence of fetal loss prior to 24 weeks, at or after 24 weeks or at any time, was assessed by comparing the relative incidence at a number of MoM or delta NT cut\u2010offs and at various centile cut\u2010offs. At various marker levels the likelihood ratio (LR) for fetal loss was also calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The rate of fetal loss increased with decreasing maternal serum free \u03b2\u2010hCG and PAPP\u2010A and increasing delta NT. At the 5<jats:sup><jats:italic>th<\/jats:italic><\/jats:sup> centile of the normal outcome group for free \u03b2\u2010hCG (0.41 MoM) the odds ratio for fetal loss before 24 weeks, at or above 24 weeks and at any gestation was 3.1, 1.8 and 2.6, respectively. The respective values for the 5<jats:sup><jats:italic>th<\/jats:italic><\/jats:sup> centile of PAPP\u2010A (0.415 MoM) were 3.3, 1.9 and 2.8 and for the 95<jats:sup><jats:italic>th<\/jats:italic><\/jats:sup> centile of delta NT they were 2.5, 1.9 and 2.2, respectively. There was almost no correlation between reduced levels (\u22640.50 MoM) of PAPP\u2010A and reduced levels of free \u03b2\u2010hCG in either the normal pregnancy group (<jats:italic>r<\/jats:italic> = 0.041) or the group with fetal death (<jats:italic>r<\/jats:italic> = 0.072), indicating relatively independent prediction by either biochemical marker.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Low levels of maternal serum PAPP\u2010A and free \u03b2\u2010hCG and increased fetal NT are associated, in the absence of an abnormal karyotype, with an increased risk of impending fetal death. The likelihood ratio profiles provided at various levels of PAPP\u2010A or free \u03b2\u2010hCG may be of some help in counseling women with such results and raise awareness among health\u2010care professionals for increased surveillance in such cases. Copyright \u00a9 2006 ISUOG. Published by John Wiley &amp; Sons, Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.3809","type":"journal-article","created":{"date-parts":[[2006,9,4]],"date-time":"2006-09-04T11:23:11Z","timestamp":1157368991000},"page":"637-643","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":89,"title":["First\u2010trimester ultrasound and biochemical markers of aneuploidy and the prediction of impending fetal death"],"prefix":"10.1002","volume":"28","author":[{"given":"K.","family":"Spencer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N. J.","family":"Cowans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Avgidou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. 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