Evaluation of ProBNP and Troponin I in Cases of Placenta Accreta Spectrum Disorders and Placenta Praevia.

Abstract

Introduction: Placenta accreta spectrum (PAS) disorders and placenta praevia (PP) are major life-threatening obstetric complications. Pro-brain natriuretic peptide (ProBNP) and troponin I are circulatory biomarkers related to increased angiogenesis and tissue destruction.

Aims and objectives: The aim was to evaluate the ProBNP and troponin I levels in placenta praevia and PAS and compare their levels between cases and their corresponding matched controls in terms of age, gestational age, and BMI.

Material and methods: A case-control study was conducted over one year; ProBNP and troponin I levels were evaluated and compared in a total of 120 women enrolled, in which 30 women were of placenta praevia, 30 women were of PAS, and 60 controls (30 each) matched to corresponding controls in terms of age, gestational age, and BMI. In all recruited women, biomarker levels were detected by immunofluorescence assay method. All cases and controls were evaluated and compared in terms of demographic profile, risk factors, and maternal and perinatal outcomes.

Results: In placenta praevia patients, lower mean ProBNP (0.42) and higher troponin I levels (1.58) were observed as compared to their matched controls, but this difference was not significant statistically. PAS patients had statistically significant higher mean ProBNP (1.24) as well as troponin I levels (3.84) as compared to their matched controls (P < 0.001) (z = 4.356).

Conclusion: Both ProBNP and troponin I levels were found to be higher in cases of PAS. Troponin I had an edge over ProBNP in the identification of PAS and adverse maternal and perinatal outcomes. Both may be used as diagnostic as well as prognostic markers in the future.