Determining the Role of Pregnancy-associated Plasma Protein-A Level in the First Trimester of Pregnancy and Clinical Outcome in an Urban Referral Centre, South India

2021 ◽  
pp. 131-146
Author(s):  
T. Lavanya ◽  
Nandita A. Thakkar ◽  
R. Premalatha
Keyword(s):  
Clinical Outcome ◽  
Plasma Protein ◽  
South India ◽  
Protein A ◽  
First Trimester ◽  
Referral Centre ◽  
First Trimester Of Pregnancy

scholarly journals Levetiracetam, lamotrigine and carbamazepine: which monotherapy during pregnancy?

2021 ◽  
Author(s):  
Luisa Mari ◽  
Fabio Placidi ◽  
Andrea Romigi ◽  
Mario Tombini ◽  
Chiara Del Bianco ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Post Partum ◽  
First Trimester ◽  
Protective Role ◽  
Seizure Freedom ◽  
Good Clinical Outcome ◽  
Heart Malformation ◽  
First Trimester Of Pregnancy ◽  
Post Partum Period

Abstract Objective Epilepsy treatment during pregnancy is still challenging. The study is aimed at comparing the efficacy and safety of carbamazepine (CBZ), lamotrigine (LTG) and levetiracetam (LEV) monotherapies during pregnancy in women with focal (FE) or generalized (GE) epilepsy. Methods A multicentre retrospective study was conducted to evaluate seizures frequency and seizure freedom (SF) rate during 3 months before pregnancy, each trimester of gestation and post-partum period in women on monotherapy with CBZ, LTG and LEV. Results Fifty-seven pregnancies (45 FE, 12 GE) on monotherapy (29 CBZ, 11 LTG, 17 LEV) were included. A significant reduction of seizure frequency was found in the first trimester of pregnancy as compared with that one before pregnancy (p = 0.004), more evident in GE (p = 0.003) and in LEV group (p = 0.004). The SF rate significantly increased in the first trimester in comparison to that one before pregnancy and persisted in the post-partum period in the whole sample (p < 0.001) and in women on LEV (p = 0.004). Besides, 88.57% of SF women before pregnancy remained unchanged during gestation and the post-partum period. One major heart malformation in CBZ and no major malformations in LTG and LEV groups were found. Conclusions A better clinical outcome during pregnancy emerged since the first trimester in comparison to the before-pregnancy period, mostly evident in women with GE and LEV therapy, reinforcing the hypothesis of a protective role of pregnancy versus seizures. SF before pregnancy represents a significant predictive factor of good clinical outcome during gestation and the post-partum period. Compared to CBZ, LTG and LEV showed a better safety profile.

scholarly journals Assessment of β-human-derived chorionic gonadotrophic hormone (βhCG) and pregnancy-associated plasma protein A (PAPP-A) levels as predictive factors of preeclampsia in the first trimester among Iranian women: a cohort study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Maryam Honarjoo ◽  
Shahnaz Kohan ◽  
Elahe Zarean ◽  
Mohammad Javad Tarrahi
Keyword(s):  
Cohort Study ◽  
Plasma Protein ◽  
Predictive Factors ◽  
Protein A ◽  
First Trimester ◽  
Health Centers ◽  
Screening Tests ◽  
Iranian Women ◽  
First Trimester Of Pregnancy ◽  
Low Levels

Abstract Background Preeclampsia (PE) is a leading cause of maternal and perinatal mortality. There are controversial findings regarding the prediction of PE through the assessment of the Pregnancy-Associated Plasma Protein A (PAPP-A) and β-Human-Derived Chorionic Gonadotrophic hormone (βhCG) levels in the first trimester of pregnancy. Therefore, this cohort study was conducted to evaluate of PAPP-A and βhCG levels as predictive factors for PE development in the first trimester among Iranian women. Methods In this cohort study, a total of 4605 volunteer Primigravida and Multigravida women were selected by the census from 16 randomly selected Health Centers in Isfahan, Iran, from July 2016 to June 2018. Eligible pregnant women participated in the study had already undergone fetal anomalies screening tests between 11 + 0 and 13 + 6 weeks of pregnancy and their PAPP-A and βhCG biomarkers were adjusted to the Multiples of the Median (MOM). MOM PAPP-A <  0.4 and MOM βhCG > 3 were considered abnormal. The samples were followed up until delivery. The biomarkers’ levels were compared in the two groups of women with and without PE and Relative risk (RR) and odds ratio (OR) of PE calculated. Results In the PE group, the mean MOM PAPP-A was significantly lower (1 vs. 1.09 with P = 0.006) and MOM βhCG was significantly higher (1.51 vs. 1.14 with P = 0.001) than the group without PE. RR and OR for PE in subjects with MOM PAPP-A <  0.4 were reported as follows: RR = 2.49, (p = 0.001) and OR = 2.09, (p = 0.001). RR and OR for PE in subjects with MOM βhCG > 3 were also reported as follows: RR = 4.02, (p = 0.001) and OR = 5.65, (p = 0.001). Adjusted OR for MOM PAPP-A <  0.4 and MOM βhCG > 3 was obtained as follows: OR = 2.09 (P = 0.001) and OR = 5.65 (P = 0.001), respectively. Conclusion The results of the study showed that the high levels of βhCG would cause 5.65 times increase and the low levels of PAPP-A would cause 2.09 times increase in the chance of developing PE.

Low maternal pregnancy-associated plasma protein A during the first trimester of pregnancy and pregnancy outcomes

2016 ◽  
Vol 136 (1) ◽  
pp. 76-82 ◽  
Author(s):  
Marja Kaijomaa ◽  
Leena Rahkonen ◽  
Veli-Matti Ulander ◽  
Esa Hämäläinen ◽  
Henrik Alfthan ◽  
...  
Keyword(s):  
Plasma Protein ◽  
Pregnancy Outcomes ◽  
Protein A ◽  
First Trimester ◽  
First Trimester Of Pregnancy

Development of a Radioimmunoassay for Pregnancy-Associated Plasma Protein A and Establishment of Normal Levels in the First Trimester of Pregnancy

1983 ◽  
Vol 20 (1) ◽  
pp. 26-30 ◽  
Author(s):  
F Anthony ◽  
G M Masson ◽  
P J Wood
Keyword(s):  
Plasma Protein ◽  
Protein A ◽  
First Trimester ◽  
Serum Samples ◽  
Double Antibody ◽  
Normal Ranges ◽  
Antibody Method ◽  
First Trimester Of Pregnancy

An accelerated double antibody method has been developed for the radioimmunoassay of pregnancy-associated plasma protein A (PAPP-A) in serum. The workable range for the assay was 0·04–1·8 mg/l of serum. PAPP-A levels were determined in single serum samples from 110 women with prospective normal pregnancies of between 7 and 14 weeks' gestation. The level of pregnancy specific β1 glycoprotein (SP1) was also measured in these samples and normal ranges for PAPP-A and SP1 were constructed from the results obtained.

Correlation of neonatal weight with maternal serum levels of pregnancy-associated plasma protein-A during the first trimester of pregnancy: a retrospective study

2015 ◽  
Vol 43 (2) ◽  
Author(s):  
Ivana Giudice ◽  
Gianfranco Benintende ◽  
Anna Maria Di Nicolò ◽  
Daniela Mangiameli ◽  
Grazia Carrara ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Fetal Growth ◽  
Plasma Protein ◽  
Protein A ◽  
Screening Method ◽  
Serum Levels ◽  
First Trimester ◽  
Maternal Serum ◽  
Perinatal Complications ◽  
First Trimester Of Pregnancy

AbstractEvaluate the relationship between neonatal weight and pregnancy-associated plasma protein-A.Retrospective study on 2564 singleton pregnancies with healthy term neonates in three groups of women with different values of pregnancy-associated plasma protein-A who underwent the combined test during the first trimester. Non-parametric test and correlation analysis for statistical elaboration were carried out.There exists a correlation between the serum levels of pregnancy-associated plasma protein-A in the first trimester of pregnancy and neonatal weight. Values of pregnancy-associated plasma protein-A lower than the 25This study confirms the positive correlation between circulating concentrations of pregnancy-associated plasma protein-A and fetal growth. Low neonatal weight and factors that can cause this could be determined from the first trimester by measuring the concentrations of pregnancy-associated plasma protein-A in maternal serum. Even if the association between the levels of pregnancy-associated plasma protein-A and a low neonatal weight has been demonstrated, however, we have to say that the sensitivity of a such screening method for the prediction of low birth weight and perinatal complications seems to be rather low. The variations of pregnancy-associated plasma protein-A during the first trimester cannot be used as a marker of excessive fetal growth.

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