Placental growth factor concentration in maternal circulation decreases after fetal death: lessons from a case series study.
OBJECTIVE
Placental growth factor (PlGF) has been suggested as a possible biomarker for major placenta-related disorders such as preeclampsia and intrauterine growth restriction. However, experimental findings suggest that PlGF concentrations may be influenced by other factors besides the placenta. In the present study, we examined how acute fetal injury affects PlGF concentrations in maternal circulation. We therefore monitored PlGF concentrations in maternal circulation before and after feticide.


METHODS
A prospective comparative study was performed. Blood samples were drawn prospectively between January and July 2012, before and after feticide at predetermined time points in relation to the procedure (0, 30, 60, and 120 min). The levels of lactate dehydrogenase (LDH) in the maternal circulation were measured to detect acute tissue damage. PlGF concentrations were measured by standard human ELISA.


RESULTS
Following feticide (60 and 120 min), PlGF concentrations decreased significantly compared to the concentrations before feticide. LDH concentrations did not change before and after feticide.


CONCLUSIONS
Our finding, along with the detailed review of the literature described in our work, supports a new concept in which primary fetal distress can affect PlGF concentration in maternal circulation. A large-scale study is required to strengthen our finding.
Department of Obstetrics and Gynecology, Soroka University Medical Center and Ben-Gurion University of the Negev, Beer-Sheva, Israel. oferbeharier@gmail.com.
Ofer
O
Beharier
Department of Physiology and Cell Biology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Eden
E
Shusterman
Department of Physiology and Cell Biology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Irit
I
Szaingurten-Solodkin
Department of Obstetrics and Gynecology, Soroka University Medical Center and Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Adi Y
AY
Weintraub
Department of Obstetrics and Gynecology, Soroka University Medical Center and Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Eyal
E
Sheiner
Department of Physiology and Cell Biology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Shani S
SS
Swissa
Department of Physiology and Cell Biology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.|Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Daniel
D
Gitler
Department of Obstetrics and Gynecology, Soroka University Medical Center and Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Reli
R
Hershkovitz
D000328:Adult; D015415:Biomarkers / Q000097:blood / Q000378:metabolism; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005313:Fetal Death; D005317:Fetal Growth Retardation / Q000097:blood; D006801:Humans; D006836:Hydro-Lyases / Q000097:blood*; D036341:Intercellular Signaling Peptides and Proteins / Q000378:metabolism; D010920:Placenta / Q000378:metabolism* / Q000473:pathology; D000072483:Placenta Growth Factor; D011225:Pre-Eclampsia / Q000097:blood; D011247:Pregnancy; D011257:Pregnancy Proteins / Q000097:blood*; D011446:Prospective Studies
D015415:Biomarkers; D036341:Intercellular Signaling Peptides and Proteins; C000608036:PGF protein, human; D011257:Pregnancy Proteins; D000072483:Placenta Growth Factor; D006836:Hydro-Lyases; C045581:lactate dehydratase
Biomarker; Feticide; Placenta-related pathology; Placental growth factor (PlGF)