A 35-year-old woman, gravida 1, para 0, comes to the office to discuss abnormal laboratory results. The patient is at 18 weeks gestation based on her last menstrual period. She drank wine during the first trimester, as she initially did not realize she was pregnant. The patient is otherwise healthy with no medical problems. She takes prenatal vitamins and no other medications. Her immunizations are up-to-date. Results of the quadruple screen performed yesterday are as follows: An ultrasound is scheduled to confirm the patient's gestational age and evaluate for fetal anomalies. Which of the following conditions is the most likely cause of this patient's analyte pattern?

Question

A 35-year-old woman, gravida 1, para 0, comes to the office to discuss abnormal laboratory results.  The patient is at 18 weeks gestation based on her last menstrual period.  She drank wine during the first trimester, as she initially did not realize she was pregnant.  The patient is otherwise healthy with no medical problems.  She takes prenatal vitamins and no other medications.  Her immunizations are up-to-date.  Results of the quadruple screen performed yesterday are as follows:  An ultrasound is scheduled to confirm the patient's gestational age and evaluate for fetal anomalies.  Which of the following conditions is the most likely cause of this patient's analyte pattern?

Quizplus · Accepted Answer

Eductional Objective: Down syndrome is the most common chromosomal anomaly.  It is associated with low levels of maternal serum Alpha-fetoprotein and estriol and increased levels of Beta-hCG and inhibin A.  Elevated alpha-fetoprotein levels are seen in multiple gestation, open neural tube defects, and abdominal wall defects.

A 35-Year-Old Woman, Gravida 1, Para 0, Comes to the Office