Cell-free placental mRNA in maternal plasma to predict placental invasion in patients with placenta accreta.
OBJECTIVE
To evaluate whether measuring cell-free placental mRNA in maternal plasma improves the diagnostic accuracy of ultrasound and color Doppler in detecting placental invasion in patients at risk for placenta accreta.


METHODS
Thirty-five singleton pregnant women of more than 28 weeks of gestation and at risk for placenta accreta underwent ultrasound and color Doppler assessment. Cell-free placental mRNA in maternal plasma was measured using real-time reverse-transcription polymerase chain reaction. Patients were classified into 2 groups based on the findings at cesarean delivery and histological examination: women with placenta accreta (n=7) and women without placenta accreta (n=28).


RESULTS
The median MoM (multiples of the median) value of cell-free placental mRNA was significantly higher in patients with placenta accreta than in those without placenta accreta (6.50 vs 2.60; P<0.001. Moreover, cell-free placental mRNA was significantly elevated in patients with placenta increta and percreta than in those with simple accreta. Six false-positive results were found on ultrasound, all from patients without placenta accreta and an insignificant rise in cell-free placental mRNA levels.


CONCLUSIONS
Measuring cell-free placental mRNA in maternal plasma may increase the accuracy of ultrasound and color Doppler in prenatal prediction of placental invasion in patients with suspected placenta accreta.
El Behery
Manal M
MM
Department of Obstetrics and Gynecology, Faculty of Medicine, Zagazig University, Zagazig, Egypt. mbhry@hotmail.com
Rasha L
Etewa
E
El Alfy
Yehya
Y
D000328:Adult; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D010921:Placenta Accreta / Q000097:blood* / Q000000981:diagnostic imaging; D011247:Pregnancy; D011446:Prospective Studies; D012333:RNA, Messenger / Q000097:blood*; D018615:Ultrasonography, Doppler, Color
D015415:Biomarkers; D012333:RNA, Messenger