Research Article
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Relationship between first and second trimester aneuploidy screening test serum analytes and placenta accreta

Year 2024, Volume: 41 Issue: 2, 290 - 293, 19.05.2024

Abstract

Placenta accreta (PA) is a serious obstetric complication associated with maternal morbidity and mortality. While ultrasonography and MRI are effective in the third trimester, early diagnosis in the first two trimesters remains elusive. This study aims to explore the utility of biochemical markers in early PA detection, addressing a critical gap in current diagnostic approaches. A retrospective analysis was conducted on patients diagnosed with placenta previa between October 2021 and December 2022. Cases were divided into PA and non-PA groups based on histopathological examination. Demographic, obstetric characteristics and serum analytes were compared between the groups to identify potential biomarkers for early PA detection. Patients with PA exhibited higher gravida, parity, and abortion numbers. First-trimester free β-hCG levels and second-trimester E3 levels were significantly elevated in the PA group compared to non-accreta cases. No significant differences were observed in PAPP-A, AFP, and second-trimester hCG levels. Additionally, postoperative leukocyte count was lower, and intrapartum bleeding frequency was higher in the PA group. Multiparity and the number of previous cesarean sections emerged as significant risk factors for PA, consistent with previous literature. While previous studies reported associations between biochemical markers and PA, this study uniquely identified significant associations with free β-hCG and E3 levels. Further research is warranted to validate these findings and elucidate their clinical implications.

References

  • Committee opinion no. 529: placenta accreta. Obstet Gynecol. Jul 2012;120(1):207-211. doi: 10.1097/AOG.0b013e318262e340.
  • Higgins MF, Monteith C, Foley M, O'Herlihy C. Real increasing incidence of hysterectomy for placenta accreta following previous caesarean section. Eur J Obstet Gynecol Reprod Biol. Nov 2013;171(1):54-56. doi: 10.1016/j.ejogrb.2013.08.030.
  • Silver RM, Landon MB, Rouse DJ, Leveno KJ, Spong CY, Thom EA, et al. Maternal morbidity associated with multiple repeat cesarean deliveries. Obstet Gynecol. Jun 2006;107(6):1226-1232. doi: 10.1097/01.Aog.0000219750.79480.84.
  • Belfort MA. Placenta accreta. Am J Obstet Gynecol. Nov 2010;203(5):430-439. doi: 10.1016/j.ajog.2010.09.013.
  • Silver RM. Placenta accreta: we can do better! Bjog. Jul 2016;123(8):1356. doi: 10.1111/1471-0528.13583.
  • Warshak CR, Eskander R, Hull AD, Scioscia AL, Mattrey RF, Benirschke K, et al. Accuracy of ultrasonography and magnetic resonance imaging in the diagnosis of placenta accreta. Obstet Gynecol. Sep 2006;108(3 Pt 1):573-581. doi: 10.1097/01.AOG.0000233155.62906.6d.
  • Comstock CH, Love JJ Jr, Bronsteen RA, Lee W, Vettraino IM, Huang RR, et al. Sonographic detection of placenta accreta in the second and third trimesters of pregnancy. Am J Obstet Gynecol. Apr 2004;190(4):1135-1140. doi: 10.1016/j.ajog.2003.11.024.
  • Lin TM, Galbert SP, Kiefer D, Spellacy WN, Gall S. Characterization of four human pregnancy-associated plasma proteins. Am J Obstet Gynecol. Jan 15 1974;118(2):223-236. doi: 10.1016/0002-9378(74)90553-5.
  • Dreux S, Salomon LJ, Muller F, Goffinet F, Oury JF, Sentilhes L. Second-trimester maternal serum markers and placenta accreta. Prenat Diagn. Oct 2012;32(10):1010-1012. doi: 10.1002/pd.3932.
  • Bartels HC, Postle JD, Downey P, Brennan DJ. Placenta Accreta Spectrum: A Review of Pathology, Molecular Biology, and Biomarkers. Disease Markers. 2018/07/03 2018;2018:1507674. doi: 10.1155/2018/1507674.
  • Sfar E, Zine S, Chaar N, Ben Ammar K, Haouat S, Zouari F, et al. [Analysis of placenta accreta risk factors. 8 case reports]. Rev Fr Gynecol Obstet. Apr 1994;89(4):202-206.
  • Dare FO, Oboro VO. Risk factors of placenta accreta in Ile-Ife, Nigeria. Niger Postgrad Med J. Mar 2003;10(1):42-45.
  • Özcan S, Karayalçın R, Kanat Pektas M, Artar I, Sucak A, Çelen S, et al. Multiple repeat cesarean delivery is associated with increased maternal morbidity irrespective of placenta accreata. Eur Rev Med Pharmacol Sci. 2015;19(11):1959-1963.
  • Thompson O, Otigbah C, Nnochiri A, Sumithran E, Spencer K. First trimester maternal serum biochemical markers of aneuploidy in pregnancies with abnormally invasive placentation. Bjog. Sep 2015;122(10):1370-1376. doi: 10.1111/1471-0528.13298.
  • Zhou J, Li J, Yan P, Ye YH, Peng W, Wang S, et al. Maternal plasma levels of cell-free β-HCG mRNA as a prenatal diagnostic indicator of placenta accrete. Placenta. Sep 2014;35(9):691-695. doi: 10.1016/j.placenta.2014.07.007.
  • Wang F, Chen S, Wang J, Wang Y, Ruan F, Shu H, et al. First trimester serum PAPP-A is associated with placenta accreta: a retrospective study. Arch Gynecol Obstet. Mar 2021;303(3):645-652. doi: 10.1007/s00404-020-05960-1.
  • Büke B, Akkaya H, Demir S, Sağol S, Şimşek D, Başol G, et al. Relationship between first trimester aneuploidy screening test serum analytes and placenta accreta. J Matern Fetal Neonatal Med. Jan 2018;31(1):59-62. doi: 10.1080/14767058.2016.1275546.
  • Gagnon A, Wilson RD. Obstetrical complications associated with abnormal maternal serum markers analytes. J Obstet Gynaecol Can. Oct 2008;30(10):918-932. doi: 10.1016/s1701-2163(16)32973-5.
  • Oztas E, Ozler S, Caglar AT, Yucel A. Analysis of first and second trimester maternal serum analytes for the prediction of morbidly adherent placenta requiring hysterectomy. Kaohsiung J Med Sci. Nov 2016;32(11):579-585. doi: 10.1016/j.kjms.2016.08.011.
Year 2024, Volume: 41 Issue: 2, 290 - 293, 19.05.2024

Abstract

References

  • Committee opinion no. 529: placenta accreta. Obstet Gynecol. Jul 2012;120(1):207-211. doi: 10.1097/AOG.0b013e318262e340.
  • Higgins MF, Monteith C, Foley M, O'Herlihy C. Real increasing incidence of hysterectomy for placenta accreta following previous caesarean section. Eur J Obstet Gynecol Reprod Biol. Nov 2013;171(1):54-56. doi: 10.1016/j.ejogrb.2013.08.030.
  • Silver RM, Landon MB, Rouse DJ, Leveno KJ, Spong CY, Thom EA, et al. Maternal morbidity associated with multiple repeat cesarean deliveries. Obstet Gynecol. Jun 2006;107(6):1226-1232. doi: 10.1097/01.Aog.0000219750.79480.84.
  • Belfort MA. Placenta accreta. Am J Obstet Gynecol. Nov 2010;203(5):430-439. doi: 10.1016/j.ajog.2010.09.013.
  • Silver RM. Placenta accreta: we can do better! Bjog. Jul 2016;123(8):1356. doi: 10.1111/1471-0528.13583.
  • Warshak CR, Eskander R, Hull AD, Scioscia AL, Mattrey RF, Benirschke K, et al. Accuracy of ultrasonography and magnetic resonance imaging in the diagnosis of placenta accreta. Obstet Gynecol. Sep 2006;108(3 Pt 1):573-581. doi: 10.1097/01.AOG.0000233155.62906.6d.
  • Comstock CH, Love JJ Jr, Bronsteen RA, Lee W, Vettraino IM, Huang RR, et al. Sonographic detection of placenta accreta in the second and third trimesters of pregnancy. Am J Obstet Gynecol. Apr 2004;190(4):1135-1140. doi: 10.1016/j.ajog.2003.11.024.
  • Lin TM, Galbert SP, Kiefer D, Spellacy WN, Gall S. Characterization of four human pregnancy-associated plasma proteins. Am J Obstet Gynecol. Jan 15 1974;118(2):223-236. doi: 10.1016/0002-9378(74)90553-5.
  • Dreux S, Salomon LJ, Muller F, Goffinet F, Oury JF, Sentilhes L. Second-trimester maternal serum markers and placenta accreta. Prenat Diagn. Oct 2012;32(10):1010-1012. doi: 10.1002/pd.3932.
  • Bartels HC, Postle JD, Downey P, Brennan DJ. Placenta Accreta Spectrum: A Review of Pathology, Molecular Biology, and Biomarkers. Disease Markers. 2018/07/03 2018;2018:1507674. doi: 10.1155/2018/1507674.
  • Sfar E, Zine S, Chaar N, Ben Ammar K, Haouat S, Zouari F, et al. [Analysis of placenta accreta risk factors. 8 case reports]. Rev Fr Gynecol Obstet. Apr 1994;89(4):202-206.
  • Dare FO, Oboro VO. Risk factors of placenta accreta in Ile-Ife, Nigeria. Niger Postgrad Med J. Mar 2003;10(1):42-45.
  • Özcan S, Karayalçın R, Kanat Pektas M, Artar I, Sucak A, Çelen S, et al. Multiple repeat cesarean delivery is associated with increased maternal morbidity irrespective of placenta accreata. Eur Rev Med Pharmacol Sci. 2015;19(11):1959-1963.
  • Thompson O, Otigbah C, Nnochiri A, Sumithran E, Spencer K. First trimester maternal serum biochemical markers of aneuploidy in pregnancies with abnormally invasive placentation. Bjog. Sep 2015;122(10):1370-1376. doi: 10.1111/1471-0528.13298.
  • Zhou J, Li J, Yan P, Ye YH, Peng W, Wang S, et al. Maternal plasma levels of cell-free β-HCG mRNA as a prenatal diagnostic indicator of placenta accrete. Placenta. Sep 2014;35(9):691-695. doi: 10.1016/j.placenta.2014.07.007.
  • Wang F, Chen S, Wang J, Wang Y, Ruan F, Shu H, et al. First trimester serum PAPP-A is associated with placenta accreta: a retrospective study. Arch Gynecol Obstet. Mar 2021;303(3):645-652. doi: 10.1007/s00404-020-05960-1.
  • Büke B, Akkaya H, Demir S, Sağol S, Şimşek D, Başol G, et al. Relationship between first trimester aneuploidy screening test serum analytes and placenta accreta. J Matern Fetal Neonatal Med. Jan 2018;31(1):59-62. doi: 10.1080/14767058.2016.1275546.
  • Gagnon A, Wilson RD. Obstetrical complications associated with abnormal maternal serum markers analytes. J Obstet Gynaecol Can. Oct 2008;30(10):918-932. doi: 10.1016/s1701-2163(16)32973-5.
  • Oztas E, Ozler S, Caglar AT, Yucel A. Analysis of first and second trimester maternal serum analytes for the prediction of morbidly adherent placenta requiring hysterectomy. Kaohsiung J Med Sci. Nov 2016;32(11):579-585. doi: 10.1016/j.kjms.2016.08.011.
There are 19 citations in total.

Details

Primary Language English
Subjects Obstetrics and Gynaecology
Journal Section Research Article
Authors

Cuma Taşın 0000-0002-9315-4791

Sabri Kurtay 0000-0003-0867-6972

Tuğba Karakaş 0000-0002-4590-9504

Publication Date May 19, 2024
Submission Date December 13, 2023
Acceptance Date April 29, 2024
Published in Issue Year 2024 Volume: 41 Issue: 2

Cite

APA Taşın, C., Kurtay, S., & Karakaş, T. (2024). Relationship between first and second trimester aneuploidy screening test serum analytes and placenta accreta. Journal of Experimental and Clinical Medicine, 41(2), 290-293.
AMA Taşın C, Kurtay S, Karakaş T. Relationship between first and second trimester aneuploidy screening test serum analytes and placenta accreta. J. Exp. Clin. Med. May 2024;41(2):290-293.
Chicago Taşın, Cuma, Sabri Kurtay, and Tuğba Karakaş. “Relationship Between First and Second Trimester Aneuploidy Screening Test Serum Analytes and Placenta Accreta”. Journal of Experimental and Clinical Medicine 41, no. 2 (May 2024): 290-93.
EndNote Taşın C, Kurtay S, Karakaş T (May 1, 2024) Relationship between first and second trimester aneuploidy screening test serum analytes and placenta accreta. Journal of Experimental and Clinical Medicine 41 2 290–293.
IEEE C. Taşın, S. Kurtay, and T. Karakaş, “Relationship between first and second trimester aneuploidy screening test serum analytes and placenta accreta”, J. Exp. Clin. Med., vol. 41, no. 2, pp. 290–293, 2024.
ISNAD Taşın, Cuma et al. “Relationship Between First and Second Trimester Aneuploidy Screening Test Serum Analytes and Placenta Accreta”. Journal of Experimental and Clinical Medicine 41/2 (May 2024), 290-293.
JAMA Taşın C, Kurtay S, Karakaş T. Relationship between first and second trimester aneuploidy screening test serum analytes and placenta accreta. J. Exp. Clin. Med. 2024;41:290–293.
MLA Taşın, Cuma et al. “Relationship Between First and Second Trimester Aneuploidy Screening Test Serum Analytes and Placenta Accreta”. Journal of Experimental and Clinical Medicine, vol. 41, no. 2, 2024, pp. 290-3.
Vancouver Taşın C, Kurtay S, Karakaş T. Relationship between first and second trimester aneuploidy screening test serum analytes and placenta accreta. J. Exp. Clin. Med. 2024;41(2):290-3.