The article presents an analysis of modern literature regarding pregnancy outcomes associated with the results of a triple test in the II trimester of pregnancy. The obtained results indicate the relationship between increased serum levels of AFP and hCG
with the risk of pregnancy complications. Serum markers, assessed in the triple test in the second trimester, can be used not only to detect aneuploidy and congenital anomalies, but also high-risk pregnancies. A triple test can help identify women at
high risk for adverse outcomes earlier in the second trimester.
Rimaz A. Gurashi, Imad Fadl-Elmula. Maternal Serum Triple Screening Test and Pregnancy Outcome in Elderly Sudanese Pregnant Ladies in Khartoum State-Sudan. American Journal of Laboratory Medicine. 2017; 2(6):172-178. https://doi.org/10.11648/j.ajlm.20170206.19
Boonpiam R., Wanapirak C., Sirichotiyakul S., Sekararithi R., Traisrisilp K., Tongsong T. Quad test for fetal aneuploidy screening as a predictor of small-for-gestational age fetuses: a population-based study. BMC Pregnancy Childbirth. 2020;15;20(1):621. https://doi.org/10.1186/s12884-020-03298-9
García-Pérez L., Linertová R., Álvarez-de-la-Rosa M., Bayón J.C., Imaz-Iglesia I., Ferrer-Rodríguez J. et al. Cost-effectiveness of cell-free DNA in maternal blood testing for prenatal detection of trisomy 21, 18 and 13: a systematic review. Eur J Health Econ. 2018;19:979–91. https://doi.org/10.1007/s10198- 017-0946-y
Sharony R., Dayan D., Kidron D., Manor M., Berkovitz A., Biron-Shental T., Maymon R. Is the ratio of maternal serum to amniotic fluid AFP superior to serum levels as a predictor of pregnancy complications? Arch Gynecol Obstet. 2016 Apr;293(4):767-70. https://doi.org/10.1007/s00404-015-3905-9.
Pakniat H., Bahman A., Ansari I. The Relationship of Pregnancy-Associated Plasma Protein A and Human Chorionic Gonadotropin with Adverse Pregnancy Outcomes: A Prospective Study. J Obstet Gynaecol India. 2019;69(5):412-419. https://doi.org/10.1007/s13224-019-01217-3
Ekici Günay N. Determination of median values of triple screening test hormones for Kayseri region and their crossregional comparisons. Perinatal Journal 2019;27(2):68-76. https://doi.org/10.2399/prn.19.0272004
Moghadam MN, Davoodi M, Behzadmehr R. Prenatal diagnosis. Journal of Medical Practice and Review. 2018; 2: 119-22.
Такоева М.А., Цахилова С.Г., Мурадова В.С., Еременко М.А. Современные аспекты диагностики и прогнозирования преждевременных родов. Эффективная фармакотерапия. 2021;17(19): 16–19. https://doi.org/10.33978/2307-3586-2021-17-19-16-19
Puntachai P., Wanapirak C., Sirichotiyakul S., Tongprasert F., Srisupundit K., Luewan S. et al: Associations between pregnancy outcomes and unexplained high and low maternal serum alphafetoprotein levels. Arch Gynecol Obstet 2015; 292: 81–85. https://doi.org/10.1007/s00404-014-3606-9
Goto E. Association of high maternal blood alpha-fetoprotein level with risk of delivering small for gestational age: a meta-analysis. Pediatr Res. 2021;89(7):1742-1750. https://doi.org/10.1038/s41390- 020-01124-8
Settiyanan T., Wanapirak C., Sirichotiyakul S., Tongprasert F., Srisupundit K., Luewan S. et al. Association between isolated abnormal levels of maternal serum unconjugated estriol in the second trimester and adverse pregnancy outcomes. J Matern Fetal Neonatal Med 2016; 29(13): 2093-7. http://dx.doi.org/10.3109/14767058.2015.1075503
Cohen J.L., Smilen K.E., Bianco A.T., Moshier E.L., Ferrara L.A., Stone J.L. Predictive value of combined serum biomarkers for adverse pregnancy outcomes. Eur J Obstet Gynecol Reprod Biol. 2014;181:89–94. http://dx.doi.org/10.1016/j.ejogrb.2014.07.018
Sehat Z., Goshtasebi A., Amin M.T. To investigate the association between triple test and preterm delivery. International Journal of Advances in Gynacology, 2019;3(2):9-12.
Kim S.Y., Kim S.K., Lee Js., Kim I.K., Lee K. The Prediction of Adverse Pregnancy Outcome using Low Unconjugated Estriol in the Second Trimester of Pregnancy without Risk of Down's Syndrome. Med. J 2000; 41(2): 226-229. https://doi.org/10.3349/ymj.2000.41.2.226
Manotaya S., Zitzler J., Li X., Wibowo N., Pham T.M., Kang M.S. et al. Effect of ethnicity on first trimester biomarkers for combined trisomy 21 screening: results from a multicenter study in six Asian countries. Prenat Diagn. 2015; 35: 735–740. https://doi.org/10.1002/pd.4602 5
Nunthapiwat S., Sekararithi R., Wanapirak C., Sirichotiyakul S., Tongprasert F., Srisupundit K., Luewan S., Tongsong T. Second Trimester Serum Biomarker Screen for Fetal Aneuploidies as a Predictor of Preterm Delivery: A Population-Based Study. Gynecol Obstet Invest 2019;84:326–333. https://doi.org/10.1159/000495614
Gündüz Ö.D., Eser A., Çoban U., Tekeli S. Evaluation of the impact of triple test results on perinatal outcomes. Perinatal Journal. 2016;24(1):26-31. https://doi.org/10.2399/prn.160241007
Dugoff L. Society for Maternal-Fetal Medicine. Society for maternal–fetal medicine first and second trimester maternal serum markers for aneuploidy and adverse obstetric outcomes. Obstet Gynecol. 2010;115:1052–61. https://doi.org/10.1097/AOG.0b013e3181da93da
Sagol S., Vidinli H., Asena U. The relation of false positivity and obstetric complications in pregnant patients screened for Down syndrome risk by triple test. EgeT›p Dergisi 2000;39:121–5.
Proctor L.K., Toal M., Keating S., Chitayat D., Okun N., Windrim R.C. et al. Placental size and the prediction of severe early-onset intrauterine growth restriction in women with low pregnancyassociated plasma protein-A. Ultrasound Obstet Gynecol. 2009;34:274–82.
https://doi.org/10.1002/uog.7308
Spaggiari E., Ruas M., Dreux S., Valat A.S., Czerkiewicz I., Guimiot F. et al. Management strategy in pregnancies with elevated second-trimester maternal serum alpha-fetoprotein based on a second assay. Am J Obstet Gynecol. 2013; 208:303.e1–7. https://doi.org/10.1016/j.ajog.2013.01.010
Hu Ji-L., Zhang Y-J., Zhang J.-M., Zhu S., Li D.-M., Yin Y-F. et al. Pregnancy outcomes of women with elevated second-trimester maternal serum alpha-fetoprotein. Taiwanese Journal of Obstetrics and Gynecology. 2020;59(1):73-78. https://doi.org/10.1016/j.tjog.2019.11.011