Document Detail

Biochemical diagnosis of placental infarction/damage: acutely rising alkaline phosphatase.
MedLine Citation:
PMID:  18482929     Owner:  NLM     Status:  MEDLINE    
There are currently no simple tests in clinical use to detect acute placental damage. A case is described to demonstrate that a routinely used measurement such as alkaline phosphatase (ALP) can be employed to detect acute damage to the placenta. Seventeen serial blood samples, three pre-delivery, were collected from a 22-year-old primigravida who delivered a stillborn baby. Retrospectively, blood samples were analysed for total and heat-stable ALP as well as human chorionic gonadotropin (hCG) and alpha-fetoprotein (AFP) as a measure of placental function when an unusual pattern of change in ALP was noticed. Histological examination of the placenta revealed new and old placental infarcts. Total and heat-stable ALPs as well as AFP peaked by more than eight-, 19- and two-fold, respectively over 16 h. Plasma hCG fell sharply even before delivery of placenta by five-fold over 16 h before further falling slowly to baseline. The fall in hCG is also consistent with the placental damage being acute and critical. As far as we are aware this is the first description of changes in circulating proteins reflecting placental damage.
L Ranganath; W Taylor; L John; Z Alfirevic
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Annals of clinical biochemistry     Volume:  45     ISSN:  0004-5632     ISO Abbreviation:  Ann. Clin. Biochem.     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-05-16     Completed Date:  2008-07-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0324055     Medline TA:  Ann Clin Biochem     Country:  England    
Other Details:
Languages:  eng     Pagination:  335-8     Citation Subset:  IM    
Department of Clinical Biochemistry and Metabolic Medicine, Royal Liverpool University Hospital, Liverpool, UK.
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MeSH Terms
Alkaline Phosphatase / blood*
Chorionic Gonadotropin / blood
Placenta Diseases / diagnosis*
alpha-Fetoproteins / metabolism
Reg. No./Substance:
0/Chorionic Gonadotropin; 0/alpha-Fetoproteins; EC Phosphatase

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