title: Placenta accreta is associated with elevated maternal serum alpha-fetoprotein.
abstract: OBJECTIVE
  To determine whether placenta accreta/percreta/increta is associated with elevation of second-trimester maternal serum alpha-fetoprotein (MSAFP) levels.
  
  
  METHODS
  We reviewed the medical records of 44 women who had emergency cesarean hysterectomy. Twenty women had placenta accreta/percreta/increta (study group) and 24 underwent cesarean hysterectomy for other indications (control group). Pertinent maternal and neonatal variables were abstracted from the prenatal records and hospital charts. Chi-square and Fisher exact tests were used to analyze categorical variables. Student t test was used to analyze continuous variables.
  
  
  RESULTS
  Nine of 20 patients (45%) with placenta accreta/percreta/increta and none of 24 subjects in the control group had an elevated MSAFP value (P < .001). Maternal estimated blood loss was also significantly greater in the study group (4469 +/- 1851 versus 1885 +/- 1113 mL; P < .0001), as was the number of blood units transfused (7.7 +/- 4.7 versus 3.0 +/- 2.2; P < .001). None of the other examined variables were different between the groups.
  
  
  CONCLUSIONS
  A significant association exists between placenta accreta/percreta/increta and elevated MSAFP values. Patients with an unexplained elevation of MSAFP may have an increased risk for placenta accreta and associated blood loss at cesarean hysterectomy.
authors.affiliation: Department of Obstetrics and Gynecology, Northwestern University Medical School, Chicago, Illinois.
authors.forename: M J
authors.initials: MJ
authors.lastname: Kupferminc
authors.forename: R K
authors.initials: RK
authors.lastname: Tamura
authors.forename: T R
authors.initials: TR
authors.lastname: Wigton
authors.forename: R
authors.initials: R
authors.lastname: Glassenberg
authors.forename: M L
authors.initials: ML
authors.lastname: Socol
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D002585:Cesarean Section; D004630:Emergencies; D005260:Female; D006801:Humans; D007044:Hysterectomy; D010921:Placenta Accreta / Q000097:blood* / Q000453:epidemiology / Q000601:surgery; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D012189:Retrospective Studies; D012307:Risk Factors; D000509:alpha-Fetoproteins / Q000032:analysis*
chemical_list: D000509:alpha-Fetoproteins