Serum Angiopoietin -1 as a biomarker of missed abortion

Abstract

ABSTRACT Background: Missed abortion (MA) is a pregnancy with an embryo without cardiac pulsation or gestational sac without embryo without attempt for expulsion of the product of conception outside the uterus. Objective: to detect the efficacy of serum Angiopoietin-1(Ang-1) as a biomarker of missed abortion at 6 to 8 weeks of pregnancy Methodology: This case-control study comprised eighty pregnant women aged 20–40 years; they were divided into; A) control group which composed of 40 women with normal viable pregnancy at the 6-8 weeks of pregnancy , B) study group that included 40 women with missed abortion diagnosed by TVUS at same gestational age. Results: This study revealed that, there was highly statistically significant decrease in serum levels of Ang-1 in missed abortion .The mean ±SD of serum Ang-1 were 926.16 ± 211.48 ( 700 – 1620.3) pg/ml in normal pregnant women, and 700.04 ± 87.87 (435.9-797.8) pg/ml in women with missed abortion. The cutoff point was ≤ 780.99 pg/ml with high sensitivity and specificity (87.5.% and 90.00% respectively). There was no correlation between the Ang-1 levels and (age, parity, and body mass index). Conclusion: Serum levels of Ang-1 were highly significantly decreased in a status of missed abortion as early as 6 to 8 weeks of conception when compared with Ang-1 levels in normal viable pregnancies of similar gestational age which indicate its role in pathogenesis of missed abortion. Angiopoietin 1 is not a reliable biomarker for instant diagnosis of missed abortion as some patients need further transvaginal ultrasound (TVUS) and regular follow up.