Early detection of Blighted ovum in pregnant women in North Darfur, Sudan

Abstract

Background and Aims: Blighted ovum, or anembryonic pregnancy, is a leading cause of early pregnancy loss, often associated with chromosomal abnormalities. Early detection is crucial for timely clinical intervention. This study evaluates maternal serum human chorionic gonadotropin (HCG) and alpha-fetoprotein (AFP) as potential biomarkers for the early detection of blighted ovum in first-trimester pregnancies. Methods: A cross-section study was conducted at Alfashir New Hospital, Northern Darfur State, Sudan, involving 194 pregnant women in their first trimester: 158 with normal pregnancies and 36 diagnosed with blighted ovum. Maternal serum samples were analyzed using immunoradiometric assays (IRMA) to measure HCG and AFP levels. Gestational age was confirmed via ultrasound and serum biomarker analysis, with results expressed as multiples of the median (MoM). Results: A significant decrease in HCG levels was observed in women with blighted ovum compared to the others (P < 0.001), whereas AFP levels showed no significant difference. This confirms that low maternal HCG levels can serve as a potential marker for early detection of blighted ovum. Conclusion: The study established local reference values for HCG and AFP in the Sudanese population. Serum HCG screening in the first trimester offers a cost-effective, non-invasive method for early diagnosis of blighted ovum. The findings suggest that locally established reference values may be more applicable than international standards.

References

1. 1.Loncar J, Barnabei VM, Larsen JW. Advent of maternal serum markers for Down syndrome screening. Obstet Gynecol Surv. 1995;50(5):316-20.
2. 2.American College of Obstetricians and Gynecologists. ACOG practice bulletin. Management of recurrent pregnancy loss. Number 24, February 2001. (Replaces Technical Bulletin Number 212, September 1995). American College of Obstetricians and Gynecologists. Int J Gynaecol Obstet. 2002 Aug;78(2):179-90. doi: 10.1016/s0020- 7292(02)00197-2. PMID: 12360906. doi:10.1016/s0020-
3. 3.West NB, Coulam CB, Kaider AS. A genetically defined animal model of anembryonic pregnancy. Hum Reprod. 1993;8(8):1316-23.
4. 4.Minelli E, Buchi C, Granata P, Meroni E, Righi R, Portentoso P, et al. Cytogenetic findings in echographically defined blighted ovum abortions. Ann Genet. 1993;36(2):107-10.
5. 5.Creasy R. The cytogenetics of spontaneous abortion in humans. In: Beard RW, Sharp F, editors. Early Pregnancy Loss: Mechanisms and Treatment. London: RCOG; 1988. p. 293-304.
6. 6.SallerDN,CanickJA.Maternalserum screening for fetal Down syndrome: clinical aspects. Clin Obstet Gynecol. 1996;39(4):783-92.
7. 7.Rushton DI. The classification and mechanisms of spontaneous abortion. Perspect Pediatr Pathol. 1984;8:269-
8. 8.Johnson MR, Riddle AF, Sharma WP, Collins WP, Nicolaides KH, Grudzinskas JG. Placental and ovarian hormones in anembryonic pregnancy. Hum Reprod. 1993;8(1):112-5.
9. 9.Jauniaux E, Jurkovic D, Gulbis B, Zaidi J, Meuris S, Campbell S. Biochemical composition of the coelomic fluid in anembryonic pregnancy. Am J Obstet Gynecol. 1994;171(3):849-53.
10. 10.Sjogren B, Uddenberg N. Decision making during the prenatal diagnostic procedure: a questionnaire and interview study of 211 women participating in prenatal diagnosis. Prenat Diagn. 1988;8(4):263-73.
11. 11.Hall JG. Chromosomal clinical abnormalities. In: Behrman RE, Kliegman R, Jenson HB, editors. Nelson Textbook of Pediatrics. 16th ed. Philadelphia: Saunders; 2000. p. 328.
12. 12.Cuckle H, Van Lith JM. Appropriate biochemical parameters in first-tri- Majmaah Journal of Health Sciences,Vol.13, Issue3, July-2025,Muharram-1447 81 Early detection of Blighted ovuminpregnantwomeninNorthDarfur,Sudan mester screening for Down syndrome. Prenat Diagn. 1999;19(6):505-12.
13. 13.Burton BK, Prins GS, Verp MS. A prospective trial of prenatal screening for Down syndrome using maternal serum alpha-fetoprotein, human chorionic gonadotropin, and unconjugated estriol. Am J Obstet Gynecol. 1993;169(3):526-30.
14. 14.Kim SY, Kim SK, Lee SR, Yon JM, Nam SY, Lee SH, et al. Influence of age on clinical outcomes of in vitro fertilization and intracytoplasmic sperm injection. Clin Exp Reprod Med. 2012;39(1):28-32. doi:10.5653/ cerm.2012.39.1.28.
15. 15.KushnirVA,BaradDH,AlbertiniDF, Darmon SK, Gleicher N. Systematic review of worldwide trends in assisted reproductive technology 2004–2013. Hum Reprod Update. 2016;22(2):228-
16. 16.doi:10.1093/humupd/dmv054 doi:10.1093/humupd/dmv054
17. 17.Singh N, Begum AA, Malhotra N, Bahadur A, Vanamail P. Role of early serum beta human chorionic gonadotropin measurement in predicting multiple pregnancy and pregnancy wastage in an in vitro fertilization cycle. J Hum Reprod Sci. 2013;6(3):213–8.
18. 18.AliNI1,SattiHA1,ZainH2,Choudhary RK4, Satti HA5. Journal of Radiation Research and Applied Sciences. The efficiency of using maternal markers in early detection and management of congenital anomalies in Majmaah city, KSA. J Radiat Res Appl Sci. 2022;15:181–5.