First trimester serum PAPP-A is associated with placenta accreta: a retrospective study

Wang, Fengge; Chen, Shuxiong; Wang, Jishui; Wang, Yangping; Ruan, Fang; Shu, Hua; Zhu, Li; Man, Dongmei

doi:10.1007/s00404-020-05960-1

Cited by 10 publications

(16 citation statements)

References 37 publications

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“… None of the markers was effective in predicting PAS. Wang et al 61 2021 First PAPP-A 177 Retrospective Elevated serum PAPP-A could significantly predict PAS. The study covered only one ethnic group (Chinese).…”

Section: Diagnosis Of Placenta Accreta Spectrummentioning

confidence: 99%

“…Therefore, this study found that the concentration of serum PAPP-A has diagnostic value for judging the high-risk cases of placenta previa accreta. Wang et al 61 conducted a retrospective cohort study of 177 pregnant women with placenta previa accreta detecting their serum PAPP-A in the first trimester. The results revealed that PAPP-A MoM of the placenta previa accreta group was considerably higher than those of the placenta previa group and control group, serum PAPP-A was associated with the occurrence of PAS.…”

Section: Diagnosis Of Placenta Accreta Spectrummentioning

confidence: 99%

“…As a biological marker of placental trophoblast, PAPP-A can predict PAS, preeclampsia, fetal growth restriction, spontaneous abortion, preterm birth, and so on. [59][60][61] Desai et al 62 measured the serum PAPP-A concentration of 16 pregnant women with placenta previa combined with PAS (accreta group) and 66 pregnant women without placenta previa and PAS (non-accreta group). The results showed that the serum PAPP-A concentration of the accreta group was 1.68 MoM, which was considerably higher than 0.98 MoM of the non-accreta group and 1.00 MoM for normal pregnant women at the same gestational age.…”

Section: Pregnancy-associated Serum Protein (Papp-a)mentioning

confidence: 99%

See 2 more Smart Citations

Placenta Accreta Spectrum Diagnosis Challenges and Controversies in Current Obstetrics: A Review

Arakaza¹,

Zou²,

Zhao³

2023

IJWH

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Background Placenta accreta spectrum (PAS) is the most common obstetric complication in current obstetrics in which the placenta is fully or partially attached to the uterine myometrial layer at delivery. This is commonly due to the deficiency of the uterine interface between the uterine endometrial and myometrial layers leading to abnormal decidualization at the uterine scar area, which permits the abnormally placental anchoring villous and trophoblasts, deeply invade the myometrium. The prevalence of PAS is globally at rising trends every day in modern obstetrics originally due to the high increasing rate of cesarean sections, placenta previa, and assisted reproductive technology (ART). Thus, the early and precise diagnosis of PAS is imperative to prevent maternal intrapartum or postpartum bleeding complications. Objective The main aim of this review is to debate the current challenges and controversies in the routine diagnosis of PAS diseases in obstetrics. Data Source We retrospectively reviewed the recent articles on different methods of diagnosing PAS in PubMed, Google Scholar, Web of Science, Medline, Embase, and other website databases. Results Despite that, the standard ultrasound is a reliable and key tool for the diagnosis of PAS, the lack of ultrasound features does not exclude the diagnosis of PAS. Therefore, clinical assessment of risk factors, MRI tests, serological markers, and placental histopathological tests are also indispensable for the prediction of PAS. Previously, limited studies reached a high sensitivity rate of diagnosis PAS in appropriate cases, while many studies recommended the inclusion of different diagnosis methods to improve the diagnosis accuracy. Conclusion A multidisciplinary squad with well-experienced obstetricians, radiologists, and histopathologists should be involved in the establishment of the early and conclusive diagnosis of PAS.

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Section: Diagnosis Of Placenta Accreta Spectrummentioning

confidence: 99%

Section: Diagnosis Of Placenta Accreta Spectrummentioning

confidence: 99%

Section: Pregnancy-associated Serum Protein (Papp-a)mentioning

confidence: 99%

See 1 more Smart Citation

Placenta Accreta Spectrum Diagnosis Challenges and Controversies in Current Obstetrics: A Review

Arakaza¹,

Zou²,

Zhao³

2023

IJWH

View full text Add to dashboard Cite

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“…Table 1 summarizes the characteristics of the studies included in the meta-analysis. In general, 7 retrospective studies [17,18,[20][21][22][23][24] and one prospective study, [19] consisting of 243 pregnant women with PAS and 1599 pregnant women without PAS, were available for the subsequent meta-analysis. These studies were conducted in the United States, the United Kingdom, Turkey, Russia, and China between 2014 and 2022.…”

Section: Study Characteristicsmentioning

confidence: 99%

Meta-analysis for the relationship between circulating pregnancy-associated plasma protein A and placenta accreta spectrum

Li,

Meng,

Chi

et al. 2023

Medicine

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Background: Changes in circulating pregnancy-associated plasma protein A (PAPP-A) have been observed in women with a placenta accreta spectrum (PAS). However, no consensus has been reached according to the previous studies. Our study investigated the relationship between circulating PAPP-A and PAS risk through a systematic review and meta-analysis. Methods: Studies comparing the circulating level of PAPP-A between pregnant women with and without PAS were obtained by searching the Medline, Cochrane Library, Embase, CNKI, and Wanfang databases from the inception of the databases until February 12, 2023. Heterogeneity was considered in the pooling of results via a random-effects model. Results: Eight observational studies were obtained for the meta-analysis, which included 243 pregnant women with PAS and 1599 pregnant women without PAS. For all these women, the first-trimester circulating level of PAPP-A was measured by immunoassay and reported as multiples of the median (MoM) values. The pooled results showed that compared to those who did not develop PAS, women with PAS had significantly higher first-trimester serum level PAPP-A (mean difference: 0.43 MoM, 95% confidence interval [CI]: 0.30 to 0.56, P < .001; I2 = 32%). Furthermore, a high first-trimester serum PAPP-A level was related to a high PAS risk (odds ratio: 2.89, 95% CI: 2.13 to 3.92, P < .001; I2 = 0%). Sensitivity analysis which excluded one study at a time, also obtained similar results (p all < 0.05). Conclusion: Pregnant women with a high serum PAPP-A level in the first trimester may be at an increased risk for PAS.

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“…Recent data suggest that low levels of PAPP-A in maternal serum is associated with abnormal placentation which may explain potential downstream maternal and fetal complications [13]. A recent retrospective study reported the interesting finding of a significant, positive association between increased first trimester serum PAPP-A levels and placenta accreta [14]. Although existing data indicate that PAPP-A is expressed at the level of the human ovary [15], specifically in granulosa cells, theca cells [16,17], follicular fluid [10], and in cumulus granulosa cell masses [18], as well as downstream in trophoblastic cells, there is lack of data regarding the potential expression of PAPP-A at the human embryonic level in vitro.…”

Section: Introductionmentioning

confidence: 99%

The expression of pregnancy-associated plasma protein-A (PAPP-A) in human blastocoel fluid–conditioned media: a proof of concept study

Kavoussi

Chen

Wininger

et al. 2022

J Assist Reprod Genet

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Purpose The aim of this study was to determine if pregnancy-associated plasma protein-A (PAPP-A), typically measured in maternal serum and a potential predictor of adverse maternal and fetal outcomes such as spontaneous miscarriage, pre-eclampsia, and stillbirth, is expressed in blastocoel fluid–conditioned media (BFCM) at the embryonic blastocyst stage. Design This is an in vitro study. Methods BFCM samples from trophectoderm-tested euploid blastocysts (n = 80) from in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) patients were analyzed for PAPP-A mRNA. BFCM was obtained from blastocyst stage embryos in 20 uL drops. Blastocysts underwent trophectoderm biopsy for preimplantation genetic testing for aneuploidy prior to blastocyst vitrification and BFCM collection for snap freezing. cfDNA was synthesized using BFCM collected from 80 individual euploid blastocysts. Next, real-time qPCR was performed to detect expression of PAPP-A with GAPDH for normalization of expression in each sample. Results PAPP-A mRNA was detected in 45 of 80 BFCM samples (56.3%), with varying levels of expression across samples. Conclusion Our study demonstrates the expression of PAPP-A in BFCM. To our knowledge, this is the first study to report detection of PAPP-A mRNA in BFCM. Further studies are required and underway to investigate a greater number of BFCM samples as well as the possible correlation of PAPP-A expression with pregnancy outcomes of transferred euploid blastocysts. If found to predict IVF and obstetric outcomes, PAPP-A may provide additional information along with embryonic euploidy for the selection of the optimal blastocyst for embryo transfer.

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First trimester serum PAPP-A is associated with placenta accreta: a retrospective study

Cited by 10 publications

References 37 publications

Placenta Accreta Spectrum Diagnosis Challenges and Controversies in Current Obstetrics: A Review

Placenta Accreta Spectrum Diagnosis Challenges and Controversies in Current Obstetrics: A Review

Meta-analysis for the relationship between circulating pregnancy-associated plasma protein A and placenta accreta spectrum

The expression of pregnancy-associated plasma protein-A (PAPP-A) in human blastocoel fluid–conditioned media: a proof of concept study

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