Pregnancy-associated plasma protein a levels are decreased in obstetric cholestasis

Obstetric cholestasis is a cholestatic disease usually commencing in the third trimester of pregnancy and characterized by pruritus, elevation of liver enzymes, and increase in bile acids. The objective of this study was to compare the first trimester serum indicators of obstetric cholestasis with n...

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Bibliographic Details
Published in:Clinical and experimental obstetrics & gynecology 2015-01, Vol.42 (5), p.617-618
Main Authors: Hançerlioğullari, N, Aktulay, A, Engin-Üstün, Y, Ozkan, M Ş, Oksuzoglu, A, Danişman, N
Format: Article
Language:English
Subjects:
Adult
Biomarkers - blood
Cholestasis, Intrahepatic - blood
Chorionic Gonadotropin, beta Subunit, Human - blood
Female
Gestational Age
Humans
Pregnancy
Pregnancy Complications - blood
Pregnancy Trimester, First
Pregnancy-Associated Plasma Protein-A - metabolism
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Summary:Obstetric cholestasis is a cholestatic disease usually commencing in the third trimester of pregnancy and characterized by pruritus, elevation of liver enzymes, and increase in bile acids. The objective of this study was to compare the first trimester serum indicators of obstetric cholestasis with normal pregnancies. Thirty-five patients diagnosed with obstetric cholestasis in a three-year period with first trimester biochemical assessment available were included in the study. Seventy patients with concordant pregnancy weeks, matched-age normal pregnancies were included as the control group. Pregnancy-associated plasma protein A (PAPP-A) and free beta-human chorionic gonadotropin (beta-hCG) levels were analyzed. No difference was observed between the two groups in terms of age and week of pregnancy. While the mean PAPP-A level was 0.76 ± 0.31 multiples of the medians (MoM) in the obstetric cholestasis group, it was determined to be 1.5 ± 0.84 in the control group (p = 0.0001). Among the two groups, the hCG levels were found to be higher in the obstetric cholestasis group (1.2 ± 0.79 MoM vs. 0.98 ± 0.53, p = 0.041). In this study, the first trimester PAPP-A levels in the obstetric cholestasis cases were found to be significantly lower than the control group. Low PAPP-A levels should be a warning for obstetric cholestasis.
ISSN:0390-6663
2709-0094
DOI:10.12891/ceog1917.2015