title: Low VEGF expression in conceptus material and maternal serum AFP and β-hCG levels as indicators of defective angiogenesis in first-trimester miscarriages.
abstract: OBJECTIVE
  The aims of this study were to assess the relationship between early miscarriages and vascular endothelial growth factor (VEGF) expression and to determine the serum levels of first-trimester maternal alpha-fetoprotein (AFP) and human chorionic gonadotropin (β-hCG) as markers of angiogenesis and predictors of abortion and intrauterine fetal loss.
  
  
  METHODS
  The present study was a prospective, single-center, randomized controlled clinical trial. Ninety-five women who were 6-10 weeks pregnant between May and June 2010 were included in the study. The subjects were divided into three groups, i.e., incomplete abortion (IA) (n=31), intrauterine death (IU-D) (n=32) and control (elective pregnancy termination) (n=32). Feto-placental materials were compared based on immune staining for VEGF in the pathology laboratory, and maternal serum samples were tested in the hormone laboratory.
  
  
  RESULTS
  Serum β-hCG levels in the patient groups were significantly lower than the controls (p=0.001). The serum AFP level was lower than the controls in the IA group while it was higher than the controls in the IU-D (p=0.016). Immunohistochemistry showed that the cytotrophoblast, syncytiotrophoblast and endometrial gland epithelium were weakly stained for VEGF in the patient groups (IA and IU-D) in comparison to the control group (p=0.06, p=0.028, p=0.006).
  
  
  CONCLUSIONS
  Early pregnancy losses are related to insufficient angiogenesis, and maternal serum AFP and β-hCG can be used as markers of angiogenesis in the first trimester.
authors.affiliation: Department of Perinatology and Family Planning, Zekai Tahir Burak Women's Health Resource and Education Hospital, Ankara, Turkey.
authors.forename: Gülşen
authors.initials: G
authors.lastname: Kutluer
authors.affiliation: Department of Perinatology and Family Planning, Zekai Tahir Burak Women's Health Resource and Education Hospital, Ankara, Turkey.
authors.forename: Nedim Mahmut
authors.initials: NM
authors.lastname: Ciçek
authors.affiliation: Department of Perinatology and Family Planning, Zekai Tahir Burak Women's Health Resource and Education Hospital, Ankara, Turkey.
authors.forename: Ozlem
authors.initials: O
authors.lastname: Moraloğlu
authors.affiliation: Department of Perinatology and Family Planning, Zekai Tahir Burak Women's Health Resource and Education Hospital, Ankara, Turkey.
authors.forename: Pervin
authors.initials: P
authors.lastname: Ertargın
authors.affiliation: Department of Perinatology and Family Planning, Zekai Tahir Burak Women's Health Resource and Education Hospital, Ankara, Turkey.
authors.forename: Esma
authors.initials: E
authors.lastname: Sarıkaya
authors.affiliation: Department of Perinatology and Family Planning, Zekai Tahir Burak Women's Health Resource and Education Hospital, Ankara, Turkey.
authors.forename: Ishak
authors.initials: I
authors.lastname: Artar
authors.affiliation: Department of Pathology, Faculty of Medicine, Gazi University, Ankara, Turkey.
authors.forename: Ozlem
authors.initials: O
authors.lastname: Erdem
keywords: AFP; Abortion; VEGF; angiogenesis; implantation; β-hCG