Maternal plasma levels of cell-free β-HCG mRNA as a prenatal diagnostic indicator of placenta accrete.

Abstract

OBJECTIVE:

Several biomarkers, including maternal serum creatinine kinase and α-fetoprotein, have been described as potential tools for the diagnosis of placental abnormalities. This study aimed to determine whether maternal plasma mRNA levels of the β subunit of human chorionic gonadotropin (β-HCG) could predict placenta accreta prenatally.

METHODS:

Sixty-eight singleton pregnant women with prior cesarean deliveries (CDs) were classified into three groups: normal placentation (35 women, control group); placenta previa alone (21 women, placenta previa group); and both placenta previa and placenta accreta (12 women, placenta previa/accreta group). Maternal plasma concentrations of cell-free β-HCG mRNA were measured by real-time reverse-transcription polymerase chain reaction and were expressed as multiples of the median (MoM).

RESULTS:

Cell-free β-HCG mRNA concentrations (MoM, range) were significantly higher in women with placenta accreta (3.65, 2.78-7.19) than in women with placenta previa (0.94, 0.00-2.97) or normal placentation (1.00, 0.00-2.69) (Steel-Dwass test, P < 0.01 and P < 0.01, respectively). In the placenta previa/accreta group, the concentration of cell-free β-HCG mRNA was significantly higher among women who underwent CDs with hysterectomy (4.41, 3.49-7.19) than among women whose CDs did not result in hysterectomy (3.20, 2.78-3.70) (Mann-Whitney U test, P = 0.012).

DISCUSSION:

An increased level of cell-free β-HCG mRNA in the maternal plasma of women with placenta accreta may arise from direct uteroplacental transfer of cell-free placental mRNA molecules.

CONCLUSIONS:

The concentration of cell-free β-HCG mRNA in maternal plasma may be applicable to the prenatal diagnosis of placenta accreta, especially to identify women with placenta accreta likely to require hysterectomy.

• Authors: J Zhou, J Li, P Yan, Y H Ye, W Peng, S Wang, X Tong Wang
• Journal: Placenta (Placenta) Vol. 35 Issue 9 Pg. 691-5 (Sep 2014) ISSN: 1532-3102 [Electronic] Netherlands
• PMID: 25063251 (Publication Type: Journal Article)
• Copyright: Copyright © 2014 Elsevier Ltd. All rights reserved.

Chemical References

• Biomarkers
• Chorionic Gonadotropin, beta Subunit, Human
• RNA, Messenger

Topics

• Adult
• Biomarkers (blood)
• Case-Control Studies
• Chorionic Gonadotropin, beta Subunit, Human (metabolism)
• Female
• Humans
• Magnetic Resonance Imaging
• Placenta (metabolism)
• Placenta Accreta (blood, diagnostic imaging)
• Placenta Previa (blood)
• Placentation
• Pregnancy
• RNA, Messenger (blood)
• Real-Time Polymerase Chain Reaction
• Ultrasonography