title: Pregnancy-associated plasma protein a levels are decreased in obstetric cholestasis.
abstract: OBJECTIVE
  Obstetric cholestasis is a cholestatic disease usually commencing in the third trimester of pregnancy and characterized by pruritus, elevation of liver enzymes, and increase in bile acids. The objective of this study was to compare the first trimester serum indicators of obstetric cholestasis with normal pregnancies.
  
  
  METHODS
  Thirty-five patients diagnosed with obstetric cholestasis in a three-year period with first trimester biochemical assessment available were included in the study. Seventy patients with concordant pregnancy weeks, matched-age normal pregnancies were included as the control group. Pregnancy-associated plasma protein A (PAPP-A) and free beta-human chorionic gonadotropin (beta-hCG) levels were analyzed.
  
  
  RESULTS
  No difference was observed between the two groups in terms of age and week of pregnancy. While the mean PAPP-A level was 0.76 ± 0.31 multiples of the medians (MoM) in the obstetric cholestasis group, it was determined to be 1.5 ± 0.84 in the control group (p = 0.0001). Among the two groups, the hCG levels were found to be higher in the obstetric cholestasis group (1.2 ± 0.79 MoM vs. 0.98 ± 0.53, p = 0.041).
  
  
  CONCLUSIONS
  In this study, the first trimester PAPP-A levels in the obstetric cholestasis cases were found to be significantly lower than the control group. Low PAPP-A levels should be a warning for obstetric cholestasis.
authors.forename: N
authors.initials: N
authors.lastname: Hançerlioğullari
authors.forename: A
authors.initials: A
authors.lastname: Aktulay
authors.forename: Y
authors.initials: Y
authors.lastname: Engin-Üstün
authors.forename: M Ş
authors.initials: MŞ
authors.lastname: Ozkan
authors.forename: A
authors.initials: A
authors.lastname: Oksuzoglu
authors.forename: N
authors.initials: N
authors.lastname: Danişman
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood*; D002780:Cholestasis, Intrahepatic / Q000097:blood*; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D005260:Female; D005865:Gestational Age; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood*; D011261:Pregnancy Trimester, First; D011266:Pregnancy-Associated Plasma Protein-A / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D018997:Chorionic Gonadotropin, beta Subunit, Human; D011266:Pregnancy-Associated Plasma Protein-A