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A Sheldrake

Publications and source records attributed to A Sheldrake.

4 recordsLinked to original sources
PubMed2000

Serum screening for Down syndrome and adverse pregnancy outcomes: a case-controlled study.

The relationship between adverse perinatal outcomes in women with false positive biochemical screening test for Down syndrome was investigated in a retrospective case-controlled study. A cohort of 4000 women who booked for routine antenatal care and opted for biochemical screening over a 22 month period was obtained. The pregnancy outcome data of 272 women with a false positive screening test for Down syndrome (risk >1 in 250) at 15-18 weeks of gestation (study group) were compared with data from 272 age and gestation matched controls with a negative Down syndrome screening test from the same population. The frequency of normal and adverse perinatal outcomes, including pre-eclampsia, isolated intrauterine growth restriction, spontaneous preterm labour and stillbirth was recorded. The incidence of adverse pregnancy outcomes was 11.9% in the study group and 8.6% in the control group. The estimated odds ratio of an abnormal outcome in the study group was 1.41 (95% CI-0.790, 2.55). The observed difference between proportion was 0.0324 (95% CI-0.022, 0.083; p=0.40). These data identify no evidence for a strong association between a false positive Down syndrome screening test result and subsequent adverse perinatal outcomes in the general population.

Case-Control Studies↗
PubMed1999

Perinatal outcome in pregnancies with a positive serum screening for Down's syndrome due to elevated levels of free beta-human chorionic gonadotropin.

OBJECTIVE: To evaluate the potential clinical use of maternal serum free beta-human chorionic gonadotropin (beta-hCG) and uterine artery Doppler investigation to screen for placenta-related adverse outcome in pregnancies at positive risk for Down's syndrome at 15-18 weeks. DESIGN: A cohort of 329 consecutive pregnant women with a singleton viable pregnancy and a positive risk for Down's syndrome was retrospectively investigated. This group was obtained from an unselected population of 3952 women attending the same hospital over a 2-year period. Using the results of this first analysis, we selected a group of 26 women with unexplained high levels of free beta-hCG and followed them prospectively with monthly ultrasound and uterine artery Doppler examinations. RESULTS: In the retrospective cohort, risk ratios stratified for maternal serum beta-hCG multiple of the median (MoM) values indicated that the highest incidence of adverse pregnancy outcome was in those women with values of > or = 5.0. In the prospective study, pregnancy outcome was complicated by uteroplacental disorders in eight cases. Analysis of the Doppler investigation indicated that, in women with a very high level of hCG, an abnormally high uterine artery pulsatility index (PI) had lower sensitivity and negative predictive value than early diastolic notch, whereas the specificity and positive predictive value were higher for a high uterine artery PI. CONCLUSIONS: These findings suggest an association between a high level of maternal serum beta-hCG at 15-18 weeks, the presence of an early diastolic notch in the uterine artery flow velocity waveform and adverse pregnancy outcome due to abnormal development of the uteroplacental circulation. Young women with an unexplained high beta-hCG level would benefit, apart from detailed sonography of the fetus and/or karyotyping, from uterine Doppler investigation and counselling about the follow-up and management of placenta-related pregnancy disorders.

Blood Flow Velocity↗