The impact of severe hyperemesis gravidarum on the triple test screening results

Objective: we aimed to determine the influence of severe hyperemesis gravidarum on the interpretation of the triple test screen results. Methods: A retrospective, case control study. The study group included 73 women who were hospitalized due to severe hyperemesis gravidarum and data regarding triple screening test was available. Data was compared with a control group consisting of low-risk patients without hyperemesis gravidarum, who underwent the triple screening test in the same laboratory and matched to the study group by maternal age and gestational age at the time of screening in a 2:1 ratio. Results: Overall, 219 gravid patients were included in the study, of whom 73 were diagnosed with severe hyperemesis gravidarum. Patients in the control group were characterized by higher weight at the time of triple test screen (53.7±10.9 vs. 59.7±14.3 years, p=0.043). No difference was found in the level of Alpha-fetoprotein or unconjugated estriol (uE3) between the groups; however the level of hCG was significantly increased in women with severe hyperemesis gravidarum (1.2977±0.82 vs. 1.0662±0.53 MoM, p=0.013). Conclusion: Increase in the level of hCG in women with severe hyperemesis gravidarum alter the results of triple test screen. This data should be incorporated when counseling patients regarding overall risk for chromosomal abnormalities.