Volume : II, Issue : II, February - 2013

Level of Papp–A in The First Trimester of Pregnancy & The Pregnancy Outcome

Dr. Mithil Patil

Abstract :

Introduction : Abnormalities in maternal analyte levels and fetal measurements obtained during first trimester screening can be a marker not only for certain chromosomal disorders and anomalies in the foetus, but for specific pregnancy complications. In particular, low maternal serum pregnancy associated plasma protein-A (PAPP-A), at 11-13 weeks\' gestation is associated with stillbirth, infant death, intrauterine growth restriction (IUGR), preterm birth and pre-eclampsia in chromosomally normal fetuses, whilst a raised nuchal translucency is associated with specific structural abnormalities and genetic syndromes.We have studied the serum Papp-A level in 176 pregnant patients ( 11- 13 wks gestation) registered at Bharati Hospital & Research Centre , Pune. All the patients undergoing testing were followed till the delivery & there neonatal outcome was also taken into the consideration. Aims & Objectives To study the pregnancy outcome in relation to the variations of Papp-A level in the first trimester of pregnancy. Material & Methods Every patient visiting the antenatal OPD are counseled for the testing of First Trimester Screening to asses the fetal well being. Patients who are registered for the delivery at our hospital are taken into the trial. Blood sample are taken at 11- 13 wks of pregnancy & sent to the PerkinElmer lab for analysis. Results were expressed in Multiple Of Median & patients having MOM value less than 0.5 were carefully observed till the delivery & thorough neonatal examination is done by paediatrician. Observations Only 17 patients were having Papp-A level less than 0.5 MOM out of which 6 number of patients had preterm delivery & two patients had fetal growth restriction. Those patients having MOM values more than 0.5 , eleven patients had preterm labor & recquired NICU for the neonatal resuscitation. Few number of patients (4 no. ) have developed gestational hypertension but controlled with medication & had term deliveries. Conclusion Though Papp-A level in the First Trimester Of Pregnancy ( 11- 13 Wks ) is an important predictor of future Obstetric outcome , it has poor positive predictive value. Papp-A MOM less than 0.5 in pregnant patients have higher risk of preterm delivery , fetal growth restriction & stillbirths along with increased incidence of hypertensive disorders of pregnancy. But alone Papp-A level can be poor predictor of future Obstetric outcome unless combined with other markers such as uterine artery Doppler velocimetry at 21 -22 wks of pregnancy, B-hcg serum concentration in pregnant mothers in the first trimester of pregnancy

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Article: Download PDF   DOI : 10.36106/ijsr  

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Dr. Mithil Patil Level of Papp-A in The First Trimester of Pregnancy & The Pregnancy Outcome International Journal of Scientific Research, Vol.II, Issue.II February 2013

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