Increased levels of second trimester maternal serum @entity160 (MSAFP) have long been established as a marker for @entity601 ( @entity601 ). In addition, decreased levels of maternal @entity11111 in the third trimester have been reported in pregnancies with anencephalic fetuses. The purpose of this study was to evaluate whether early second trimester unconjugated serum @entity11111 (uE3) is an independent predictor of @entity601 . The study included 57,031 @entity1 who underwent maternal serum screening with MSAFP at 14-22 weeks gestation. Of these, 23,415 also had uE3 measurements. There were 63 cases of @entity1591 , an overall incidence of 1.1 per 1,000. Elevated MSAFP (> or =2.5 MOM) was detected in 1,346 @entity1 , 48 of which had @entity601 . Decreased uE3 (< or =0.5) was detected in 1,437 @entity1 , 17 of which had @entity601 . The incidence of @entity601 was significantly higher in @entity1 with low uE3, compared to @entity1 with normal/high uE3 (1.15% vs. 0.09%, P < 001). Finally, 51 @entity1 had both increased MSAFP and decreased uE3; 16 of these had @entity601 , 14 of which were anencephalics. In conclusion, both elevated MSAFP and low maternal serum @entity11111 are predictive of @entity1591 but have a low sensitivity. The combination of abnormally elevated MSAFP and low @entity11111 is highly predictive of @entity1591 in particular @entity10413 .

Combination of elevated maternal serum @entity160 (MSAFP) and low @entity11111 is highly predictive of XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity11111 :: ('MESH:D004964', 'Chemical') :: ['estriol'] @entity10413 :: ('MESH:D000757', 'Disease') :: ['anencephaly'] @entity160 :: ('174', 'Gene') :: ['alpha-fetoprotein'] @entity601 :: ('MESH:D009436', 'Disease') :: ['NTDs', 'neural tube defects'] @entity1591 :: ('80199', 'Gene') :: ['NTD']
@entity10413 :: (MESH:D000757,Disease) :: ['anencephaly']
