Differences in the levels of some serum biomarkers in pregnant women with pathological placentation (PAS and placenta previa) compared with the physiological course of pregnancy
DOI:
https://doi.org/10.15574/HW.2025.5(180).3139Keywords:
high-risk pregnancy, biochemical markers, prediction, placenta previa, PASAbstract
Placenta previa (PP) and placental invasion anomalies (placenta acreta spectrum - PAS) are an urgent problem of modern obstetrics. The study of biomarker levels of the above nosologies is currently considered to have good prospects in terms of improving the method of diagnosing PP and PAS.
Aim - to investigate the levels of Osteopontin (OPN), Soluble fms-like tyrosine kinase-1 (sFLT-1) and Placental growth factor (PlGF) in serum in pregnant women with PAS, with placenta previa and with a physiological course of pregnancy.
Materials and methods. A prospective case-control study conducted for the period 2024-2025. The study included 143 pregnant women with a gestational age of 25-26 weeks, who were divided into groups: the first - 43 pregnant women with placenta accreta spectrum (PAS) type placental invasion disorder, the second - 49 pregnant women with placenta previa without PAS, the control group consisted of 51 pregnant women with a physiological course of pregnancy. The levels of OPN, sFlt-1 and PlGF in blood plasma were tested and the sFlt-1/PlGF ratio was calculated.
The results of the study of OPN, sFlt-1 and PlGF levels in serum showed: the distribution of continuous variables was asymmetric, differences were found between the groups in sFlt-1, PlGF and sFlt-1/PlGF and no differences in OPN. PlGF levels in the serum of pregnant women of the second and control groups did not differ. The sFlt-1/PlGF ratio was significantly reduced in the first group compared to the second and control groups. Comparative ROC analysis showed that the highest specificity and sensitivity for the diagnosis of PAS had the sFlt-1/PlGF ratio, sFlt-1, PlGF and OPN levels had no prognostic significance.
Conclusions. The level of OPN in serum in the second trimester in PAS and PP disorders does not differ from that in normal pregnancy. The level of PlGF is increased in PAS, but the results are contradictory. The level of sFlt-1 in PAS is significantly reduced. The ratio of sFlt-1/PlGF in PAS is significantly lower than normal and has the highest sensitivity and specificity in their prediction.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the institution mentioned in the paper. The informed consent of the patient was obtained for conducting the studies.
No conflict of interests was declared by the authors.
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