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The association between preeclampsia and placental disruption induced by chorionic villous sampling
Author(s) -
Farina Antonio,
Hasegawa Junichi,
Raffaelli Simonetta,
Ceccarini Chiara,
Rapacchia Giuseppina,
Pittalis M. Carla,
Brondelli Lorena,
Righetti Francesca,
Rizzo Nicola
Publication year - 2010
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.2528
Subject(s) - preeclampsia , chorionic villus sampling , medicine , receiver operating characteristic , confidence interval , pregnancy associated plasma protein a , chorionic villi , obstetrics , andrology , gestation , prenatal diagnosis , pregnancy , gynecology , fetus , biology , first trimester , genetics
Objectives The objectives of this study were (1) to evaluate if the elevation of maternal serum α‐feto protein (MSAFP) and pregnancy‐associated placental protein‐A (PAPP‐A) in the maternal blood after chorionic villous sampling (CVS) is associated with a higher preeclampsia (PE) rate and (2) to verify the clinical utility of the analytes elevation for predicting PE. Methods A prospective study on 106 subjects who underwent CVS was performed. At the time of CVS, two blood samples were obtained for MSAFP and PAPP‐A dosage, the first just before the procedure, and the second one 30 min after the procedure. Cases with abnormal karyotype, major anomalies or preterm delivery were subsequently excluded. The ratio between the two samples was calculated as Σ (MSAFP or PAPP‐A post‐CVS/MSAFP or PAPP‐A pre‐CVS) and it was related to subsequent occurrence of PE. Results The rate of PE was 5.7% (6/106). Both MSAFP and PAPP‐A levels were higher after than before CVS (median ratio = 8.33 and 1.08, respectively). Cases developing PE had significantly higher MSAFP ratio (11.6 vs 7.4, p ‐value = 0.04) and PAPP‐A ratio (1.13 vs 1.08, p ‐value = 0.009) than those who did not develop PE. Receiver operating characteristic curve analysis showed that PAPP‐A ratio was a better predictor of subsequent PE than MSAFP ratio: at a fixed false positive rate of 10%, the detection rates for MSAFP and PAPP‐A ratios were 33 and 50%, respectively. Conclusion The elevation of MSAFP and PAPP‐A observed with CVS is associated with increased risk of subsequent PE. The ability of such increases to predict PE appears to be modest. Copyright © 2010 John Wiley & Sons, Ltd.