产前母体血清生物标志物可预测胎盘早剥谱系障碍。

IF 3 2区医学 Q2 DEVELOPMENTAL BIOLOGY

Placenta Pub Date : 2024-10-03 DOI:10.1016/j.placenta.2024.10.002

Apichote Wihakarat , Kamonnut Singkhamanan , Savitree Pranpanus

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引用次数: 0

摘要

导言：胎盘滞留症（PAS）是指胎盘与子宫壁异常粘连，并伴有不同程度的侵袭，是导致产妇发病和死亡的主要原因，并与严重的产后出血有关。PAS 可通过超声波检查或磁共振成像诊断；许多中心缺乏 PAS 诊断方面的专业知识。因此，我们研究了选定的母体血浆蛋白生物标志物--抗凝血酶-III（AT-3）、纤溶酶原激活物抑制剂-I（PAI-I）、可溶性血管内皮生长因子受体-II（sVEGFR-2）和可溶性Tie-II（sT-2）--在产前筛查PAS高风险孕妇时的性能：这项前瞻性研究于 2021 年 9 月至 2022 年 5 月在一家三甲医院进行，研究对象包括妊娠 28 周至 42 周疑似前置胎盘的孕妇。研究人员收集了每位孕妇的四份血清样本，以评估血清浓度，并对前置胎盘组（对照组）和 PAS 组进行比较。分析了生物标志物的筛查性能，并建立了 PAS 的最佳筛查模型：结果：共纳入 22 名 PAS 妇女和 18 名单纯前置胎盘妇女（n = 40）。PAS组中PAI-I、AT-3、sVEGFR-2和sT-2的中位浓度分别为21.2、6154.6、7.5和12.8纳克/毫升。PAS的最佳筛查模型是将所有四种生物标志物与剖宫产史相结合（灵敏度为77%，特异性为89%，AUC为0.87）：讨论：在有剖宫产史的妇女中结合使用四种母体血清生物标记物是最有希望的产前筛查 PAS 的模型：结论：四种母体血清生物标志物与剖宫产史的结合是最有希望用于产前筛查 PAS 的模型。

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Antenatal maternal serum biomarkers as a predictor for placenta accreta spectrum disorders

Introduction

Placenta accreta spectrum (PAS) disorder, an abnormal adherence of the placenta to the uterine wall, with variable degrees of invasion, is a major cause of maternal morbidity and mortality associated with severe postpartum hemorrhage. PAS is diagnosed using ultrasonography or with magnetic resonance imaging; in many centers there is a lack of PAS diagnostic expertise in diagnosing. Hence, we investigated the performance of selected maternal plasma protein biomarkers, antithrombin-III (AT-3), plasminogen activator inhibitor-I (PAI-I), soluble vascular endothelial growth factor receptor-II (sVEGFR-2), and soluble Tie-II (sT-2) for prenatal screening in pregnancies at a high risk of PAS.

Methods

This prospective study, conducted in a tertiary hospital from September 2021 to May 2022, included pregnant women with placenta previa suspicious of PAS between 28 and 42 weeks of gestation. Four serum samples were collected from each woman to evaluate serum concentrations and compared between placenta previa (control) and PAS groups. The screening performances of the biomarkers were analyzed, and the best screening model for PAS was created.

Results

Twenty-two women with PAS and 18 with placenta previa alone were included (n = 40). The median concentrations of PAI-I, AT-3, sVEGFR-2, and sT-2 among the PAS group were 21.2, 6154.6, 7.5, and 12.8 ng/mL, respectively. The best screening model for PAS combined all four biomarkers with a history of cesarean delivery (77 % sensitivity, 89 % specificity, and an AUC of 0.87).

Discussion

A combination of the four maternal serum biomarkers in women with a history of cesarean delivery presented the most promising model for prenatal screening of PAS.

Conclusion

A combination of the four maternal serum biomarkers with a history of cesarean delivery presented the most promising model for prenatal screening of PAS.

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来源期刊

Placenta 医学-发育生物学

CiteScore

6.30

自引率

10.50%

发文量

391

审稿时长

78 days

期刊介绍： Placenta publishes high-quality original articles and invited topical reviews on all aspects of human and animal placentation, and the interactions between the mother, the placenta and fetal development. Topics covered include evolution, development, genetics and epigenetics, stem cells, metabolism, transport, immunology, pathology, pharmacology, cell and molecular biology, and developmental programming. The Editors welcome studies on implantation and the endometrium, comparative placentation, the uterine and umbilical circulations, the relationship between fetal and placental development, clinical aspects of altered placental development or function, the placental membranes, the influence of paternal factors on placental development or function, and the assessment of biomarkers of placental disorders.