Prospects for the use of biochemical markers in placental in-growth

Abstract

Placental in-growth is a severe obstetric pathology characterized by invasive placentation and associated with a high-risk of life-threatening hemorrhage. Despite the widespread use of instrumental methods of examination, timely diagnosis of placental in-growth is a challenging issue. Here, we reviewed the existing biochemical markers used for early detection and confirmation of placental in-growth, their specificity and sensitivity, and correlation with gestational age. Significant results were found for the following substances: pregnancy-associated plasma protein A (PAPP-A) in the first trimester, alpha-fetoprotein (AFP) and human beta-chorionic gonadotropin (Beta-hCG) in the second trimester, brain natriuretic peptide, antithrombin III, plasminogen activator inhibitor type I, soluble Tie-2 receptor (endothelial cell-specific tyrosine kinase receptor), and soluble vascular endothelial growth factor receptor-2. Our findings support the use of the aforementioned biomarkers as screening method for placental in-growth in medical practice.