Abstract
Background: Preeclampsia occurs more often in dichorionic than in monochorionic twin pregnancy. We hypothesize that serum concentrations of biomarkers: placental growth factor (PlGF), serum soluble fms-like tyrosine kinase-1 (sFlt-1), and endoglin (Eng) differ between monochorionic and dichorionic twin pregnancies. Methods: A prospective observational study including 43 monochorionic and 36 dichorionic twin gestation was conducted. Blood samples were collected twice from all participants: between 11 + 0 and 13 + 6 and between 32 + 0 and 34 + 0 weeks of gestation. PlGF, sFlt-1 and Eng were measured using immnunoenzymatic assays. Results: We found a significantly higher concentration of sFlt-1 in dichorionic in comparison to monochorionic pregnancies in both the first and third trimesters. PlGF and sEng levels did not differ between mono- and dichorionic gestation in both study periods. sFlt-1 level was related to twin gestation chorionicity, while PlGF expression was not. PlGF, sFlt-1 and sEng concentrations increased significantly during gestation and were much higher in the third trimester compared to the values measured in the first trimester. Conclusions: Angiogenic biomarkers expression differ between dichorionic and monochorionic twin pregnancy. The sFlt-1 level is related to chorionicity of a twin gestation.
Highlights
Preeclampsia (PE) is one of the major causes of maternal and fetal morbidity and mortality worldwide [1,2]
A few of these proteins were proved to play a role in PE development in singleton gestation: placental growth factor (PlGF), serum soluble fms-like tyrosine kinase-1 and endoglin (Eng) and, they serve as biomarkers of PE [4]
Gestational age was calculated on the basis of a first day of last menstrual period or a transfer day in assisted reproduction techniques procedures and verified by the crown-rump length (CRL) measured on the first trimester scan
Summary
Preeclampsia (PE) is one of the major causes of maternal and fetal morbidity and mortality worldwide [1,2]. A few of these proteins were proved to play a role in PE development in singleton gestation: placental growth factor (PlGF), serum soluble fms-like tyrosine kinase-1 (sFlt-1) and endoglin (Eng) and, they serve as biomarkers of PE [4]. PlGF serum levels increase during singleton pregnancy, with highest expression at about 30–32 weeks of gestation, followed by a decrease [3]. Eng is a transmembrane glycoprotein, which plays a role as an accessory receptor for the transforming growth factor-beta (TGF-β) It affects the signalling pathways of TGF-β and endothelial nitric oxide synthase and, have a significant influence on the angiogenic processes [7]. We hypothesize that serum concentrations of biomarkers: placental growth factor (PlGF), serum soluble fms-like tyrosine kinase-1 (sFlt-1), and endoglin (Eng) differ between monochorionic and dichorionic twin pregnancies. PlGF, sFlt-1 and sEng concentrations increased significantly during gestation and were much higher in the third trimester compared to the values measured in the first trimester
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