title: Maternal level of pregnancy-associated plasma protein A as a predictor of pregnancy failure in threatened abortion.
abstract: Threatened miscarriage is a common complication of pregnancy. Despite initial viability confirmation by ultrasound scan, some of these patients had further spontaneous abortion. A highly sensitive and specific biomarker would be useful to determine the outcome of pregnancy and to prevent emotional impact to these women. A prospective 14-month cohort study was conducted in the Obstetrics and Gynaecology Department of Universiti Kebangsaan Malaysia Medical Centre to determine whether low serum levels of pregnancy-associated plasma protein A (PAPP-A) measured in early pregnancy can predict the outcome of threatened abortion. 42 pregnant women between 6 to 22 weeks of gestation with threatened abortion and 40 controls were enrolled. Serum samples were collected at presentation and PAPP-A was assayed by electrochemiluminescent immunoassay technique. Pregnancies were followed-up until 22 weeks of gestations and the outcome documented. Nine patients (11%) developed spontaneous abortion and 73 patients (89%) had successful pregnancy. The median PAPP-A level was significantly lower in patients with spontaneous abortion compared to those who had successful pregnancies in the threatened abortion group: 0.78 MoM (0.41-1.00 MoM) vs 1.00 MoM (1.00-2.0 MoM) respectively (p < 0.05). The best sensitivity of 44% and specificity of 93% were obtained at the cut of value of 0.66 MoM (95% CI, 0.561-0.773). In conclusion, low PAPP-A value in threatened abortion women is associated with pregnancy failure, although the use of PAPP-A as a one-time single marker has limited value.
authors: Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia. drhanita@ppukm.ukm.edu.my
authors: O
authors: O
authors: Hanita
authors: O
authors: O
authors: Roslina
authors: M I Nor
authors: MI
authors: Azlin
mesh_terms: D000033:Abortion, Threatened / Q000097:blood* / Q000175:diagnosis / Q000208:ethnology; D000328:Adult; D002681:China / Q000208:ethnology; D015331:Cohort Studies; D005260:Female; D005313:Fetal Death / Q000097:blood* / Q000175:diagnosis; D006801:Humans; D007194:India / Q000208:ethnology; D008296:Malaysia / Q000208:ethnology; D011237:Predictive Value of Tests; D011247:Pregnancy / Q000097:blood*; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D011266:Pregnancy-Associated Plasma Protein-A / Q000378:metabolism*; D011446:Prospective Studies
chemical_list: D011266:Pregnancy-Associated Plasma Protein-A