Document Detail

First-trimester serum analytes, biophysical tests and the association with pathological morphometry in the placenta of pregnancies with preeclampsia and fetal growth restriction.
MedLine Citation:
PMID:  21324404     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: We test the hypothesis that first-trimester serum analytes, 4-D power Doppler placental vascular indices and uterine artery Doppler (UAD) predicts abnormal placental morphometry in pregnancies with preeclampsia (PE) and fetal growth restriction (FGR).
STUDY DESIGN: Maternal serum analytes (PAPP-A, hCG, ADAM12s, and PP13), bilateral UADs, and placental vascular indices were measured at 11-14 weeks in a nested-case control study within a prospective cohort of women followed from the first-trimester to delivery. Vascularization index (VI), flow index (FI), and vascularization flow index (VFI) were obtained from 4-D power Doppler histograms. Serum analytes were measured using immunofluorometric assays and values converted to multiples of the median (MoM) for gestational age. Morphometric analysis was performed on placentas from pregnancies complicated by PE (n = 13), gestational hypertension (HBP, n = 7) and FGR (defined as fetal weight <10th percentile with abnormal umbilical artery Doppler: n = 7); and 20 uncomplicated pregnancies. Two pregnancies had both FGR and PE. Each placenta was weighed and random samples taken, and fixed in formalin within 1 h of delivery. Hematoxylin & Eosin stained slides were analyzed by design-based stereology to quantify linear dimensions, surface areas and volumes of placental components. Paired t-test and ANOVA with adjustments for multiple comparisons were used.
RESULTS: The surface areas of terminal and intermediate villi as well as the volume of terminal villi were significantly smaller in placentas from pregnancies complicated by FGR and PE. Compared with the control group the mean PAPP-A (MoM) was lower in the pregnancies with abnormal placenta morphometry (1.1 ± 0.5 versus 0.7 ± 0.5, P = 0.03). The morphometric indices were lower in those pregnancies with low PAPP-A and IUGR compared with preeclampsia.
CONCLUSION: First-trimester PAPP-A levels are associated with abnormal placental morphometry at delivery in pregnancies with PE and IUGR. These findings may explain the association between adverse pregnancy outcomes and first-trimester PAPP-A.
A O Odibo; Y Zhong; M Longtine; M Tuuli; L Odibo; A G Cahill; G A Macones; D M Nelson
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Publication Detail:
Type:  Journal Article     Date:  2011-02-13
Journal Detail:
Title:  Placenta     Volume:  32     ISSN:  1532-3102     ISO Abbreviation:  Placenta     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-03-22     Completed Date:  2011-07-01     Revised Date:  2013-06-30    
Medline Journal Info:
Nlm Unique ID:  8006349     Medline TA:  Placenta     Country:  England    
Other Details:
Languages:  eng     Pagination:  333-8     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Elsevier Ltd. All rights reserved.
Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine and Ultrasound, Washington University, St. Louis, MO 63110, USA.
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MeSH Terms
ADAM Proteins / blood
Case-Control Studies
Chorionic Gonadotropin, beta Subunit, Human / blood
Fetal Growth Retardation / blood*,  pathology,  physiopathology
Galectins / blood
Hypertension, Pregnancy-Induced / blood,  pathology
Membrane Proteins / blood
Placenta / blood supply,  pathology*
Placenta Diseases / ultrasonography
Pre-Eclampsia / blood*,  physiopathology
Pregnancy Proteins / blood
Pregnancy Trimester, First
Pregnancy-Associated Plasma Protein-A / analysis
Grant Support
Reg. No./Substance:
0/Chorionic Gonadotropin, beta Subunit, Human; 0/Galectins; 0/LGALS13 protein, human; 0/Membrane Proteins; 0/Pregnancy Proteins; EC 3.4.24.-/ADAM 12 protein; EC 3.4.24.-/ADAM Proteins; EC 3.4.24.-/Pregnancy-Associated Plasma Protein-A

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