Blood test could improve detection of potentially fatal pregnancy complication: study

The identification of proteins associated with potentially fatal complications of pregnancy has raised hopes that doctors can detect problems before delivery and act to reduce risk.

Placental adhesion spectrum (PAS) occurs when the placenta penetrates the body. Depending on the severity of PAS, the placenta either attaches to the muscles of the uterus or penetrates deeper and becomes lodged in the bladder or other organs. contributes to 900 maternal deaths that occur during childbirth in the United States.

About half of PAS cases are detected using ultrasound before delivery, allowing physicians to take steps to reduce the risk of catastrophic maternal bleeding and death. However, I need a tool that can detect other cases.

Write to journal scientific reportBrigham and Women’s Hospital, diagnostic startup NX Prenatal, and other organizations shared details of their research to address unmet needs. We conducted a human-controlled nested case-control study and found a circulating microparticle (CMP) protein panel that identifies pregnancies complicated by PAS.

CMPs are extracellular vesicles that enable intercellular communication. Using liquid chromatography with size exclusion chromatography and tandem mass spectrometry, scientists separated and identified her CMP protein at the maternal-fetal interface in plasma samples taken at various time points during pregnancy. Did.

The researchers found five CMP proteins that differentiated PAS patients from controls in samples taken after a median 26 weeks of gestation. The average area under the curve (AUC) for the five proteins was 0.83. AUC is an overall summary of diagnostic accuracy, with 0.5 indicating the test is no better than a coin toss and 1 indicating perfect. From samples taken after 35 weeks, four proteins with AUCs of her 0.78 were found.

The protein finding, coupled with other changes such as iron homeostasis, suggest that blood panels may be used to detect PAS in the second and third trimesters of pregnancy.

Dr. Hope Yu, a physician in maternal-fetal medicine at Brigham University, explained the importance of such tests in a statement.

“Identification of these cases before delivery is critical. If PAS cases can be identified during pregnancy, patients can make the potentially life-saving choice of delivery in a tertiary delivery center with specialist specialists. We can,” said Dr. Yu. provider. Having an experienced multidisciplinary team by your side during PAS delivery can make a big difference when it comes to mortality and morbidity outcomes.

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