Serum Angiogenic and Anti-angiogenic Markers in Pregnant Women with Placenta Percreta

Abstract

Background: Placenta percreta is the morbidly adherentform of all the placental invasion abnormalities. Thepathology that underlies placenta percreta is poorlyunderstood.Aims: To compare the levels of circulating vascularendothelial growth factor, placental growth factor andsoluble fms-like tyrosine kinase 1 in pregnant womenwith placenta percreta to a control group.Study Design: Case-control study.Methods: Twenty-two women who underwentcaesarean section due to placenta percreta and 22 womenwho underwent caesarean section for other obstetricreasons were included in this study. The diagnosis ofplacenta percreta was defined as extreme trophoblasticinvasion involving serosa of the uterus. Venous bloodsamples were collected for biochemical comparison ofcirculating vascular endothelial growth factor, placentalgrowth factor and soluble fms-like tyrosine kinase 1from all pregnant women.Results: Women with placenta percreta weresignificantly older, had higher gravidity, received morefrequent antenatal steroids and blood transfusions anddelivered at an earlier gestational age when comparedto the control group. In women with placenta percreta,preoperative circulating levels of vascular endothelialgrowth factor, placental growth factor and soluble fmsliketyrosine kinase 1 were lower than the controls(p