Obstetric Outcome in Pregnant Patients with Low Level of Pregnancy-Associated Plasma Protein A in First Trimester
| Autor: | Aleksandra Atanasova-Boshku, Viktorija Jovanovska, Vesna Livrinova, Igor Petrov, Igor Samardziski, Milena Gjorgjievska, Irena Todorovska, Slagjana Simeonova-Krstevska |
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| Rok vydání: | 2018 |
| Předmět: |
First trimester
medicine.medical_specialty the Perinatal outcome Pregnancy-associated plasma protein A Birth weight lcsh:Medicine Intrauterine growth restriction Factor screening Preeclampsia 03 medical and health sciences perinatology 0302 clinical medicine medicine Fetus 030219 obstetrics & reproductive medicine Placental abruption Obstetrics business.industry lcsh:R General Medicine Clinical Science 030224 pathology medicine.disease In utero Medicine Gestation business |
| Zdroj: | Open Access Macedonian Journal of Medical Sciences, Vol 6, Iss 6, Pp 1028-1031 (2018) Open Access Macedonian Journal of Medical Sciences Open Access Macedonian Journal of Medical Sciences; Vol 6, No 6 (2018): Jun 20 (OAMJMS); 1028-1031 Open Access Macedonian Journal of Medical Sciences; Vol 6 No 6 (2018): Jun 20 (OAMJMS); 1028-1031 |
| ISSN: | 1857-9655 |
| DOI: | 10.3889/oamjms.2018.238 |
| Popis: | BACKGROUND: Pregnancy-associated plasma protein A (PAPP-A), is a protease which releases Insulin-like growth factor. The role of this factor is stimulation of cell mitosis, differentiation and trophoblastic invasion of deciduas. Identification of patients with low PAPP-A (under 0.4 MoM in the first trimester has an influence on birth weight, attenuation of fetal growth, preeclampsia, birth and fetal demise.AIM: The main issue in the study is evaluating an influence of PAPP-A, calculated in the first trimester on the unfavourable outcome of pregnancy.MATERIAL AND METHODS: Seventy pregnant women with singleton pregnancy underwent first-trimester biochemical screening. The target group were women with PAPP-A below 0.4 MoM, and in control group, PAPP-A were оver 0.4 MoM. There was an assessment of the influence on the mode of delivery, gestational week, the presence of intrauterine growth restriction, preeclampsia, temporary birth, intrauterine fetal demise and newborn condition.RESULTS: In target group, consisted of 35 patients, 16 were delivered at term. From 28 to 37 g.w.- were 7 patient, 22-28 g.w.- 4 and 8 patients were under the 22 g.w (all with fetal demise) there were 19 pretemporary deliveries - 9 with Cesarean Section (SC). In the target group: 5 newborn wеre with IUGR, 6 women had preeclampsia, 1 had placental abruption. In control group were 35 patients: 28 delivered at term, 9 with SC, 26 vaginal deliveries; with IUGR were 4 newborns. Two newborns were hypertrophic.CONCLUSION: There is a significant difference in unfavourable outcome in the cases with PAPP-A under 0.4 Mom, particular in the group, with a PAPP-A value under 0.2 MoM. The patients delivered with SC with the main indications in utero hypoxia, growth restriction and elevated blood pressure had PAPP-A between 0.3-0.4 MoM. The patients with intrauterine fetal death and placental abruption in the most of the cases have PAPP-A value under 0.2 MoM. There is a need to be aware in these pregnancies to achieve the preventions of adverse outcome, to decrease perinatal morbidity and mortality. |
| Databáze: | OpenAIRE |
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