Concentration of pregnancy-associated plasma protein A (PAPP-A) in patients with pre-eclamptic toxaemia.

The plasma concentration of PAPP-A has been measured in 84 patients with pre-eclamptic toxaemia within 24 hours of their first admission to hospital. There were 51 patients who suffered from mild pre-eclampsia (late pregnancy hypertension without albuminuria). The PAPP-A values in these patients did not differ significantly from the normal value for the corresponding stage of gestation. On the other hand, the PAPP-A levels in albuminuric (severe) pre-eclampsia were significantly higher than normal; a finding which was more pronounced in those patients who presented with severe pre-eclampsia relatively early in pregnancy. It is unusual for a placental product to be raised in the presence of putative placental damage and it is suggested that PAPP-A might be involved with causal mechanisms in pre-eclampsia.