Possible association of medications during pregnancy with low estriol level of the triple antenatal screening test

Abstract

Objective: Our purpose was to reach the reasons of isolated low levels of maternal serum unconjugated estriol (uE3) levels (≤0.3 multiples of the median (MoM)) in the triple-marker screen with special emphasis on maternal diseases and medications used for them. Methods: Single center retrospective cross-sectional analysis. Of 13,367 non-smoking women with identified singleton pregnancies screened for triple test, during 3-year period (2007–2009), a group of women with isolated low serum uE3 levels (≤0.3 MoM) (n = 14) were selected as the study group. Results: Of these 14 women, no one gave birth with ichthyosis. Five patients had, isolated very low uE3 levels (<0.01 MoM). Of these women, one had umbilical cord knot, one was on corticosteroid and three were on propylthiouracil treatment. So, there was history of maternal drug intake in 28.5% of cases with isolated low uE3 (≤0.3 MoM). This rate increases to 80% in cases with very low uE3 levels (<0.01 MoM). Conclusions: Maternal diseases and medications used during pregnancy can affect fetus and antenatal screening test results. This is important during counseling of patients and to perform the appropriate antenatal and postnatal evaluation of the mother and fetus with multidisciplinary approach.

Keywords::

• Estriol
• propylthiouracil
• triple-marker screen

Declaration of Interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.