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RCOG World Congress 2023
June 12 - 14, 2023 | London, UK
EP.0884
First trimester Pregnancy Associated Plasma Protein-A as predictor of Pre-eclampsia and Fetal-Growth-Restriction
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High Risk Pregnancy
Title-FIRSTTRIMESTERPREGNANCY ASSOCIATED PLASMA PROTEIN-A(PAPP-A) AS A PREDICTOR OF PRE- ECLAMPSIA AND FETAL GROWTH RESTRICTION (FGR).
Shiwani Tripathi , Modhusmita Chetia
St Stephens hospital, New Delhi , INDIA
Introduction
ØFGR and pre-eclampsia are major obstetrics complications with perinatal morbidity and mortality.
ØPlacental pathology can lower PAPP-A levels which can be used as a biochemical marker.
ØLow PAPP-A levels with normal chromosomes, descriptive of poor early placenta resulting in complications
Aim
ØTo determine whether value of first trimester maternal serum PAPP-A level can be used as a predictor of pre-eclampsia and FGR.
Method
ØPatients underwent 1st trimester Dual marker test.
ØPAPP-A. Multiple of median (MoM) calculated and value less than or equal to 0.5 MoM was considered low.
ØAll patients followed till delivery and association of PAPP-A value with FGR and Pre-eclampsia seen.
Results
ØIn this study 69 patients out of 350 cases had low serum PAPP-A levels forming 19.71%.
ØOut of 69 cases with low PAPP-A levels 25 cases developed pre-eclampsia(p<0.0001). Out of 278 cases with normal PAPP-A only 3 patients developed pre- eclampsia
ØOut of 69 cases with low PAPP-A levels, 20 cases developed FGR forming almost 25% with statistically significant relation (p<0.001). Of 278 cases with normal PAPP-A value only 3 patients developed FGR comprising 1.07%.
Discussion
ØIt is important to design a screening technique which has good predictive value and is also cost-effective, hence bring down the incidence of maternal and fetal complications.
ØMore recent studies in concordance with ours have shown that the first trimester low levels of PAPP-A are associated with not only risk of Down’s syndrome but also adverse effects due to placental insufficiency.
Conclusion
ØLow level of first trimester serum PAPP- A have statistically significant association with development of pre-eclampsia and FGR in third trimester of pregnancy.