Abstract
Objective To evaluate whether placental protein-13 (PP-13) measured in the
serum of pregnant women could predict abnormal invasive placentation (AIP)
detected by color Doppler ultrasound (US) and magnetic resonance imaging scan in
addition to the routine US scan during the third trimester.
Materials and methods The prospective case-control study included patients
subdivided in 2 groups: 42 pregnant women with a singleton pregnancy at
28–32 weeks of gestation with only suspected AIP, and 32 healthy
pregnant women. The serum PP-13 levels were measured in both groups using an
enzyme-linked immunosorbent assay (ELISA) method and statistically compared. The
cases of AIP were confirmed by placental histopathological examination
and/or the uterus removed by hysterectomy after elective caesarean
section.
Results Serum PP-13 levels of pregnant women with AIP were significantly
higher (p<0.001) than those of controls (650.32±387.33 vs.
231.43±94.33). Statistical analysis of maternal serum PP-13 levels above
the threshold of 312 pg/ml (measured in the early third trimester)
predicted AIP with 76.2% sensitivity and 75% specificity.
Conclusion Maternal serum PP-13 may have a role in the pathophysiology of
AIP owing to its high serum value in the AIP group. The maternal serum dosage of
PP-13 levels could improve pregnancy management in those patients suspected of
having AIP.
Key words
Abnormal invasive placentation - Placenta acreta - Placenta increta - Placenta percreta - Placental protein-13 - Pregnancy