title: Maternal plasma levels of cell-free β-HCG mRNA as a prenatal diagnostic indicator of placenta accrete.
abstract: OBJECTIVE
  Several biomarkers, including maternal serum creatinine kinase and α-fetoprotein, have been described as potential tools for the diagnosis of placental abnormalities. This study aimed to determine whether maternal plasma mRNA levels of the β subunit of human chorionic gonadotropin (β-HCG) could predict placenta accreta prenatally.
  
  
  METHODS
  Sixty-eight singleton pregnant women with prior cesarean deliveries (CDs) were classified into three groups: normal placentation (35 women, control group); placenta previa alone (21 women, placenta previa group); and both placenta previa and placenta accreta (12 women, placenta previa/accreta group). Maternal plasma concentrations of cell-free β-HCG mRNA were measured by real-time reverse-transcription polymerase chain reaction and were expressed as multiples of the median (MoM).
  
  
  RESULTS
  Cell-free β-HCG mRNA concentrations (MoM, range) were significantly higher in women with placenta accreta (3.65, 2.78-7.19) than in women with placenta previa (0.94, 0.00-2.97) or normal placentation (1.00, 0.00-2.69) (Steel-Dwass test, P < 0.01 and P < 0.01, respectively). In the placenta previa/accreta group, the concentration of cell-free β-HCG mRNA was significantly higher among women who underwent CDs with hysterectomy (4.41, 3.49-7.19) than among women whose CDs did not result in hysterectomy (3.20, 2.78-3.70) (Mann-Whitney U test, P = 0.012).
  
  
  CONCLUSIONS
  An increased level of cell-free β-HCG mRNA in the maternal plasma of women with placenta accreta may arise from direct uteroplacental transfer of cell-free placental mRNA molecules.
  
  
  CONCLUSIONS
  The concentration of cell-free β-HCG mRNA in maternal plasma may be applicable to the prenatal diagnosis of placenta accreta, especially to identify women with placenta accreta likely to require hysterectomy.
authors: Department of Obstetrics and Gynecology, Provincial Hospital Affiliated to Shandong University, 324 Jingwu Road, Jinan, China; Department of Obstetrics and Gynecology, the Affiliated Hospital of Qingdao University, Qingdao, China.
authors: J
authors: J
authors: Zhou
authors: Department of Obstetrics and Gynecology, the Affiliated Hospital of Qingdao University, Qingdao, China.
authors: J
authors: J
authors: Li
authors: Department of Emergency Medicine, Qingdao Municipal Hospital, Qingdao, China.
authors: P
authors: P
authors: Yan
authors: Department of Obstetrics and Gynecology, the Affiliated Hospital of Qingdao University, Qingdao, China.
authors: Y H
authors: YH
authors: Ye
authors: Department of Obstetrics and Gynecology, the Affiliated Hospital of Qingdao University, Qingdao, China.
authors: W
authors: W
authors: Peng
authors: Department of Obstetrics and Gynecology, Provincial Hospital Affiliated to Shandong University, 324 Jingwu Road, Jinan, China.
authors: S
authors: S
authors: Wang
authors: Department of Obstetrics and Gynecology, Provincial Hospital Affiliated to Shandong University, 324 Jingwu Road, Jinan, China. Electronic address: wxt65@yahoo.com.
authors: X Tong
authors: XT
authors: Wang
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000378:metabolism*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D010920:Placenta / Q000378:metabolism; D010921:Placenta Accreta / Q000097:blood* / Q000000981:diagnostic imaging; D010923:Placenta Previa / Q000097:blood*; D010929:Placentation; D011247:Pregnancy; D012333:RNA, Messenger / Q000097:blood; D060888:Real-Time Polymerase Chain Reaction; D014463:Ultrasonography
chemical_list: D015415:Biomarkers; D018997:Chorionic Gonadotropin, beta Subunit, Human; D012333:RNA, Messenger
keywords: Cell-free placenta mRNA; Placenta accreta; Prenatal diagnosis; β-HCG