Low levels of PAPP-A and perinatal complications

Abstract

espanolObjetivo: evaluar el porcentaje de aparicion de eventos adversos perinatales en pacientes con PAPP-A baja en el primer trimestre del embarazo. En segundo plano, identificar la via y edad gestacional media de finalizacion de la gestacion. Establecer las causas de las cesareas. Realizar un protocolo de seguimiento en pacientes con PAPP-A baja. Material y metodos: Estudio longitudinal, observacional, prospectivo, descriptivo y analitico. Se evaluo a 450 gestantes con PAPP-A Resultados: El 71,6 % de las gestantes con PAPP-A Conclusiones: El porcentaje de eventos adversos en nuestras pacientes con PAPP-A baja fue elevado, presentandolos aproximadamente 7 de cada 10 gestantes. La PAPP-A baja se podria utilizar como predictor de complicaciones gestacionales, ya que se determina hoy en dia en casi todas las gestantes, y su interpretacion podria favorecer la evolucion de la gestacion, sin un aumento del coste por embarazada. EnglishObjective: the main objective was to assess the rate of occurrence of adverse perinatal events in patients with low levels of PAPP-A in the first trimester of pregnancy. The secondary objectives were to identify the route of delivery and mean gestational age at the end of pregnancy, identify the reasons for cesarean delivery, and conduct a follow-up protocol in patients with low PAPP-A. Material and methods: we performed a longitudinal, observational, prospective, descriptive, and analytical study of 450 pregnant women with PAPP-A Results: obstetric complications were detected in 71.6% of pregnant women with PAPP-A The mean gestational age at the end of pregnancy was 37 weeks. With regard to the route of delivery, 70% of patients had a vaginal delivery, while 30% of patients had a cesarean delivery. The 3 main reasons for cesarean delivery were elective cesarean (9%), suspected loss of fetal wellbeing (8.7%), and HELLP syndrome (4.9%). Conclusions: adverse events were very frequent in patients with low levels of PAPP-A (70%). Low PAPP-A could be used as a predictor of obstetric complications, since it is now determined in almost all pregnant women. Interpretation of PAPP-A findings could favor the progress of pregnancy, with no increased cost per patient.