Increased level of cell-free placental mRNA in a subgroup of placenta previa that needs hysterectomy.
OBJECTIVE
The purpose of this study was to investigate whether cell-free placental mRNA levels have the potential to predict a placenta previa resulting in hysterectomy.


METHODS
Twenty-eight singleton pregnant women with placenta previa were classified into the following four groups: 16 women with placenta located at a posterior part of the uterine wall (Group A); 4 each with placenta located at the anterior wall without (Group B) or with (Group C) previous cesarean section; and the other 4 with a history of previous cesarean section and who had the placenta located at an anterior part of uterine wall and underwent a cesarean hysterectomy (Group D). The maternal plasma concentrations of the cell-free placental lactogen (PL) mRNA measured by real-time reverse-transcription polymerase chain reaction (PCR) were converted into multiples of the median (MoM).


RESULTS
The MoM (range) values of cell-free PL mRNA in the control group and Groups A to D were 1.00 (0.39-2.35), 2.04 (0.91-3.93), 2.58 (1.90-3.90), 3.50 (1.20-4.30), and 6.28 (5.24-7.63), respectively. The concentration of cell-free PL mRNA was significantly higher in Group D than in Group A, B, or C (Mann-Whitney's U-test, P < 0.05).


CONCLUSIONS
The cell-free PL mRNA concentration in maternal plasma has the potential to predict a subgroup of placenta accreta resulting in hysterectomy.
Miura
Kiyonori
K
Department of Obstetrics and Gynecology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. kiyonori@nagasaki-u.ac.jp
Miura
Shoko
S
Yamasaki
Kentaro
K
Yoshida
Atsushi
A
Yoshiura
Koh-Ichiro
K
Nakayama
Daisuke
D
Niikawa
Norio
N
Masuzaki
Hideaki
H
D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007044:Hysterectomy; D010865:Pilot Projects; D010921:Placenta Accreta / Q000097:blood* / Q000000981:diagnostic imaging / Q000601:surgery; D010923:Placenta Previa / Q000097:blood* / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D011247:Pregnancy; D012333:RNA, Messenger / Q000097:blood*; D016216:Ultrasonography, Prenatal
D015415:Biomarkers; D012333:RNA, Messenger