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Maternal serum placental growth factor at 11–13 weeks' gestation and fetal cardiac defects
Author(s) -
Llurba E.,
Syngelaki A.,
Sánchez O.,
Carreras E.,
Cabero L.,
Nicolaides K. H.
Publication year - 2013
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.12346
Subject(s) - medicine , interquartile range , fetus , gestation , placental growth factor , gestational age , fetal echocardiography , pregnancy , obstetrics , cardiology , endocrinology , prenatal diagnosis , vascular endothelial growth factor , genetics , vegf receptors , biology
Objective To investigate the relationship between fetal heart defects and maternal serum placental growth factor ( PlGF ), a marker of placental angiogenesis. Methods Maternal serum PlGF , pregnancy‐associated plasma protein‐A ( PAPP ‐A) and uterine artery pulsatility index ( UtA‐PI ) at 11–13 weeks' gestation were compared in 68 cases of isolated fetal major heart defects and 340 normal controls. Variables were converted into multiples of the median ( MoM ) after adjustment for gestational age, maternal age, racial origin, weight, parity and method of conception, and then compared between groups. The cardiac defects included 11 cases of obstruction of the left ventricular outflow tract ( LVOT ), 25 conotruncal abnormalities and 32 valve defects. Results The median PlGF‐MoM in the heart defect group was lower than in controls (0.80 (interquartile range ( IQR ), 0.57–1.08) vs 1.00 ( IQR , 0.79–1.32); P < 0.0001). Low PlGF levels were observed in the presence of conotruncal and valve defects but not in the presence of LVOT defects. There was no significant difference between the group with fetal heart defects and controls in PAPP ‐A‐ MoM (0.95 ( IQR , 0.68–1.28) vs 1.01 ( IQR , 0.70–1.39); P = 0.292) or UtA‐PI‐MoM (1.01 ( IQR , 0.84–1.28) vs 0.99 ( IQR , 0.80–1.20); P = 0.396). Conclusion In pregnancies with isolated fetal heart defects there is evidence of impaired placental angiogenesis in the absence of impaired placental perfusion and function. Copyright © 2012 ISUOG. Published by John Wiley & Sons Ltd.