DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20221452

Early trimesterprediction of hypertensive disorders in pregnancy using pregnancy associated plasma protein A

Usha B. N., A. Prajwala

Abstract


Background: The prediction of hypertension in first trimester is fairly a new concept in recent years , studies combining various parameters in the first trimester of pregnancy have been undertaken but an combination with high predictive value is to be developed. The objective of this study is to predict preeclampsia in first trimester using pregnancy associated plasma protein A.

Methods: A prospective cohort study was done at the department of obstetrics and gynaecology JJM medical college, Davangere, Karnataka with pregnant women attending the antenatal OPD at 11-14 weeks of gestation. A pre-formed questionnaire was filled for the enrolled women then blood pressure was recorded, pregnancy associated plasma protein A (PAPPA) done at 11-14 weeks of pregnancy. IBM SPSS version 22 for windows was used for statistical analysis of data.

Results: Low PAPPA itself is not a strong indicator of preeclampsia; studies have previously shown a significant improvement in detection by combining with other biophysical, biochemical parameters.

Conclusions: In the present study, PAPPA was not found to be the predictor of preeclampsia.


Keywords


Blood pressure, Pregnancy associated plasma protein A, Preeclampsia

Full Text:

PDF

References


Mishra R, Singh BM. Ian Donald’s practical obstetric problems, 7th ed. United States of America: Elsevier; 2014:142.

Pijnenborg R. Trophoblastic invasion of human decidua from 8-18 week of pregnancy. Pacenta. 1980; 1:3-19.

Kam EPY, Gardner L. The role of trophoblast in physiological change in decidual spiral arterires. Human Reprod. 1999;14:2131-8.

Brosens IA. Morphological changes in the uteroplacental bed in pregnancy hypertension. Clin Obstet Gynaecol. 1997;99:573-93.

Kohen G. Villous development and pathogenesis of IUGR in intrauterine growth restriction. Br J Obstet Gynecol. 1990;99:342-8.

Trudinger BJ. uteroplacental blood flow velocity- time waveforms in normal and complicated Pregan Br J Obstet Gynaecol. 1985;92:39-45.

Ducey J. Complications of hypertension in pregnancy based on Doppler velocimetry. Am J Obstet Gynaecol. 1987;157:680-5.

Papageorghiou AT. The role of uterine artery Doppler in predicting the adverse pregnancy outcome. Best Pract Res Clin Obstet Gynaecol. 2004;18:383-96.

Narang S, Agarwal A, Das V, Pandey A, Agarwal S, Ali W. Prediction of preeclampsia at 11-14 weeks of pregnancy using mean arterial pressure, uterine artery Doppler and pregnancy associated plasma protein A. Int J Reprod Contracept Obstet Gynaecol. 2016;5: 3948-53.

Kuc S, Koster MPH, Franx A, Schielen PCJI, Visser GHA. Maternal characteristics mean arterial pressure and serum markers in early prediction of preeclampsia. PLoS One. 2013;8(5):e63546.

Poon L C, Akolekar R, Lachmann R, Nicolaides KH. Hypertensive disorders in preganacy: Screening by uterine artery Doppler , blood pressure and serum PAPPA at 11-13. Prenat Diagn. 2010;30:216-23.

Manjusha S , Nimbargi V. Incidence of pregnancy induced hypertension and prescription pattern of antihypertensives drugs in pregnancy. J Reprod Contracept Obstet Gynaecol 2014;5:163-70.

Spencer K, Cowan NJ, Nicolaides KH. Low levels of maternal serum PAPPA in the first trimester and the risk of preeclampsia. Prenat Diagn. 2008;28:7-10.

Velauther L, Plana ML, Kalidindi M. First trimester uterine artey Doppler and adverse pregnancy outcome: A metaanalysis involving 55,974. Ultrasound Obstet Gynaecolgy. 2014;43(5)500-7.

Poon LCY. First trimester maternal serum PAPPA and pregnancy. 2008;33:23-33.

Narges Z et al .Placental protein 13 (PP13) and PAPPA in first and second trimester: Predictive factors for preeclampsia?. ISRN Obstet Gynaecol. 2012;4:1-6.