Unexplained elevations of maternal serum XXXX in women with antiphospholipid antibodies: a harbinger of @entity5617 .

@entity1 @entity6677 @entity3556 @entity160 @entity4555 @entity1188 @entity393 @entity5617 @entity2241
OBJECTIVE: To determine whether unexplained elevations of maternal serum @entity160 (MSAFP) in women with antiphospholipid antibodies are associated with adverse pregnancy outcomes. METHODS: A retrospective cohort study was used to compare pregnancy outcomes between @entity1 with second-trimester MSAFP values equal to or greater than 2.5 multiples of the median (MoM) and less than 2.5 MoM. The cohort included 60 pregnancies in 47 @entity1 with medium to high positive levels of immunoglobulin (Ig) G anticardiolipin antibodies, @entity4555 , or both. RESULTS: Thirteen pregnancies (22%) had elevated MSAFP values (median 3.6 MoM, range 2.5-12.6). Of these, amniotic fluid AFP was normal in seven and elevated in one. None of the elevated MSAFP levels were explained by @entity2241 , current @entity5617 , @entity6677 , incorrect dates, or @entity3556 . Pregnancies with elevated MSAFP values had a significantly higher incidence of @entity5617 (eight of 13, 62%, versus three of 47, 6%) and perinatal loss (ten of 13, 77%, versus seven of 47, 15%) than those with normal MSAFP (P < .001, Fisher exact test). In these @entity1 , the sensitivity and specificity of an unexplained elevated MSAFP level in ascertaining @entity5617 were 73 and 90%, respectively. For perinatal loss, the sensitivity was 59% and the specificity was 93%. Of the placentas studied, @entity1188 occurred in eight of nine (89%) among the @entity1 with elevated MSAFP. CONCLUSIONS: Unexplained second-trimester elevations of MSAFP are common in women with antiphospholipid antibodies and are significantly associated with fetal loss. Abnormalities in the fetoplacental barrier are implicated as part of the pathophysiology of antiphospholipid antibody-mediated @entity393 .
