Role of pregnancy associated plasma protein-A and doppler velocimetry in the assessment of fetomaternal outcome in high risk pregnancy

Authors

  • Asmita Kaundal Department of Obstetrics and Gynaecology, Lady Hardinge Medical College, New Delhi, India
  • Usha Gupta Department of Obstetrics and Gynaecology, Lady Hardinge Medical College, New Delhi, India
  • Jayashree Bhattcharjee Department of Biochemistry, Lady Hardinge Medical College, New Delhi, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20191955

Keywords:

Adverse pregnancy outcome, High risk pregnancy, PAPP-A, Uterine artery PI

Abstract

Background: The study aimed at defining the role of Pregnancy associated plasma protein-A (PAPP-A) and uterine artery doppler (Ut.A.PI) in the development of adverse pregnancy outcome (APO) in high risk pregnancies.

Methods: This was an observational study where 100 singleton pregnancies at high risk of development of APO, between 11 to 13 + 6 weeks POG were enrolled. PAPP-A levels were measured at 11 to 13 + 6 weeks POG and uterine artery doppler PI was measured at 20 weeks. Women were followed till delivery. Pregnancy outcome were seen and a cut off at which APO developed was derived.

Results: In this study women with lower mean PAPP-A (0.75±0.19 MOM versus 1.23±0.31MOM) (p<0.001) values and higher Ut.A.PI (1.43±0.35MOM versus 0.99±0.25MOM) (p<0.001) developed APO. Cut off value for PAPP-A and Ut.A.PI was determined and was found to be ≤11.65 µg/ml (≤0.79MoM) and   >1.42 (>1.19MoM) respectively which was higher than what is determined in other studies done on low risks populations thereby suggesting for an intervention or more meticulous observations at a higher cut offs.

Conclusions: PAPP-A and uterine artery doppler are already being used for the screening of preeclampsia in most of the countries but not for other adverse pregnancy outcomes. PAPP-A levels along with the uterine artery PI in predicting APO in high risk women has high negative predictive value. Hence can be uses as a screening method in high risk population whether they should be used for low risk population also needs further evaluation.

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References

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Published

2019-04-29

How to Cite

Kaundal, A., Gupta, U., & Bhattcharjee, J. (2019). Role of pregnancy associated plasma protein-A and doppler velocimetry in the assessment of fetomaternal outcome in high risk pregnancy. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 8(5), 1981–1989. https://doi.org/10.18203/2320-1770.ijrcog20191955

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Original Research Articles