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Placenta accreta is associated with elevated maternal serum alpha-fetoprotein
M J Kupferminc1, R K Tamura, T R Wigton
1Department of Obstetrics and Gynecology, Northwestern University Medical School, Chicago, Illinois.
Obstetrics and Gynecology
|August 1, 1993
Summary
Elevated second-trimester maternal serum alpha-fetoprotein (MSAFP) levels are significantly associated with placenta accreta/percreta/increta. This finding may indicate an increased risk for this condition and associated blood loss during cesarean hysterectomy.
Area of Science:
- Maternal-fetal medicine
- Obstetrics
- Gynecologic surgery
Background:
- Placenta accreta spectrum disorders pose significant risks during delivery.
- Second-trimester maternal serum alpha-fetoprotein (MSAFP) screening is routine in prenatal care.
Purpose of the Study:
- To investigate the association between elevated second-trimester MSAFP levels and placenta accreta/percreta/increta.
- To assess if MSAFP can serve as a potential marker for this high-risk obstetric condition.
Main Methods:
- Retrospective review of 44 women undergoing cesarean hysterectomy.
- Comparison of 20 women with placenta accreta/percreta/increta (study group) against 24 controls.
- Statistical analysis using Chi-square, Fisher exact, and Student t tests.
Main Results:
- 45% of women with placenta accreta/percreta/increta had elevated MSAFP, compared to 0% in the control group (P < .001).
- Significantly higher maternal blood loss and blood transfusions were observed in the study group.
- No other maternal or neonatal variables differed significantly between groups.
Conclusions:
- A significant association exists between placenta accreta/percreta/increta and elevated MSAFP.
- Unexplained elevations in MSAFP may suggest an increased risk for placenta accreta and associated surgical complications.