Document Detail

Evidence of an imbalance of angiogenic/antiangiogenic factors in massive perivillous fibrin deposition (maternal floor infarction): a placental lesion associated with recurrent miscarriage and fetal death.
MedLine Citation:
PMID:  23333548     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Massive perivillous fibrin deposition (MPFD) is associated with serious complications of pregnancy including recurrent spontaneous abortion, fetal growth restriction, and fetal demise. The aim of this study was to determine whether maternal plasma concentrations of angiogenic/antiangiogenic factors in MPFD differ from those of uncomplicated pregnancies.
STUDY DESIGN: This retrospective longitudinal case-control study included MPFD cases (n = 10) and control patients (n = 175) with uncomplicated pregnancies who were enrolled in a longitudinal study and delivered at term. Serial plasma concentrations of placental growth factor (PlGF), soluble endoglin (sEng), and soluble vascular endothelial growth factor receptor (sVEGFR)-1 and -2 were determined by an enzyme-linked immunosorbent assay (cases, n = 28 samples; controls, n = 723 samples). Individual analyte concentrations were averaged across gestational age at specimen collection intervals. Linear mixed models were used to test for differences in log-transformed mean analyte concentrations both overall and as a function of time.
RESULTS: The following results were found: (1) patients with MPFD had a lower mean plasma PlGF concentration (P = .03) and higher mean plasma concentrations of sVEGFR-1 and sEng (both P < .01) than controls, adjusted for potential confounders; (2) the mean plasma concentration of PlGF differed further among cases and controls as a function of gestational age interval (P < .0001); however, mean sVEGFR-1 and sEng group differences as a function of gestational age interval approached but did not reach significance (P = .09 and P = .11, respectively); (3) patients with MPFD had lower mean plasma concentrations of PlGF/sVEGFR-1 (P < .0001) and PlGF/sEng (P < .001): both of these relationships differed further as a function of gestational age interval (both P < .0001); and (4) differences in mean sVEGFR-1, sEng, and the ratios of PlGF to sVEGFR-1 and PlGF to sEng were observed before 20 weeks of gestation.
CONCLUSION: An imbalance of angiogenic/antiangiogenic factors is present in patients with MPFD prior to the diagnosis. We propose that these changes participate in the mechanisms responsible for adverse pregnancy outcomes in patients with MPFD.
Amy E Whitten; Roberto Romero; Steven J Korzeniewski; Adi L Tarca; Alyse G Schwartz; Lami Yeo; Zhong Dong; Sonia S Hassan; Tinnakorn Chaiworapongsa
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Intramural     Date:  2013-01-17
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  208     ISSN:  1097-6868     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-03-27     Completed Date:  2013-06-17     Revised Date:  2014-04-01    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  310.e1-310.e11     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2013 Mosby, Inc. All rights reserved.
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MeSH Terms
Abortion, Habitual / blood,  etiology
Angiogenesis Inducing Agents / blood*
Angiogenesis Inhibitors / blood*
Case-Control Studies
Fetal Death / blood,  etiology
Fibrin / analysis
Longitudinal Studies
Placenta Diseases / blood*,  diagnosis*
Young Adult
Grant Support
Reg. No./Substance:
0/Angiogenesis Inducing Agents; 0/Angiogenesis Inhibitors; 9001-31-4/Fibrin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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