Maternal serum concentrations of pregnancy associated placental protein A and pregnancy specific {beta}-1-glycoprotein in multifetal pregnancies before and after fetal reduction |
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Authors: | Abbas Anthony; Sebire Neil J; Johnson Mark; Bersinger Nicholas; Nicolaides Kypros H |
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Institution: | 1The Harris Birthright Research Centre for Fetal Medicine, King's College Hospital Medical School London, UK
2Academic Department of Obstetrics and Gynaecology, The Chelsea and Westminster Hospital London, UK
3The Department of Obstetrics and Gynaecology Endocrinology, University of Berne Beme, Switzerland |
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Abstract: | Placental function in multifetal pregnancies before and afterembryo reduction was investigated by measuring maternal serumconcentrations of pregnancy associated placental protein-A (PAPP-A)and pregnancy specific -1-glycoprotein (SP-1). Three groupsof pregnant women were studied following assisted reproduction;groups 1 and 2, were 12 singleton and 12 twin pregnancies respectively,and group 3 comprised 12 women with multifetal pregnancies undergoingembryo reduction. PAPP-A and SP-1 were measured serially at821 weeks gestation. In all pregnancies, maternal serumPAPP-A and SP-1 increased with gestation. In twin pregnanciesthe mean concentrations of SP-1 were significantly higher thanin singletons at all gestations, whereas for PAPP-A, concentrationswere similar between these groups. In multifetal pregnanciesbefore embryo reduction, the serum concentrations of both proteinswere significantly higher than in twin pregnancies. Followingreduction, the concentrations of PAPP-A remained significantlyhigher than for twins throughout, whereas the concentrationsof SP-1 gradually converged towards those of twins; by 19 weeksthere was no difference between the means of the two groups.These findings suggest that circulating concentrations of SP-1reflect total placenta mass, which is proportional to the numberof live fetuses, whereas the pattern of PAPP-A changes suggeststhat this protein is produced by the placenta, decidua and othertissues. |
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Keywords: | embryo reduction/multifetal pregnancy/pregnancy associated placental protein A/pregnancy-specific -1-glyco-protein" target="_blank">gif" ALT="{beta}" BORDER="0">-1-glyco-protein |
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