Alpha-Fetoprotein for Prediction of Placenta Accreta in Women with Complete Placenta Previa Centeralis: A Prospective Study
DOI:
https://doi.org/10.37506/ijphrd.v11i3.2561Keywords:
Alpha-fetoprotein, Prediction, Placenta accreta, Placenta previa, Prospective StudyAbstract
Background: Placenta accreta (PA) is a major life-threating obstetrical burden associated with high morbidity
and mortality. This study aims to evaluate the ability of alpha-fetoprotein for prediction of placenta accreta
in women with complete placenta previa centeralis.
Method: This is a prospective study carried out at Minia Maternity University Hospital, Egypt during the
period from October 2017 to March 2019. This study included a total of 100 pregnant women who are
admitted to the hospital for CS between 28:38 weeks of gestation. They were classified into 2 groups (50
women per each), group (I) Diffuse PA: include women with diffuse placenta accreta and group (II) Control
group: include women with normally implanted placenta.
Results: Both groups were comparable regarding age, residence and parity however, diffuse PA group had
significantly higher number of cases with ? 4 previous CSs and positive history of placenta previa. Group
(I) had lower postoperative heamoglobin and platelet count (p<0.01). Serum alpha-fetoprotein concentration
was significantly higher in PA group compared to control (1.33 ± 0.38 vs. 0.66 ± 0.22 MoM, p<0.01). Also,
group (I) had higher amount of blood transfused units and longer duration of hospital stay compared to
control group (all p<0.01). Incidence of complications was obviously higher in PA group (41 cases, 82%,
p<0.01). The results of the predictive value of serum alpha-fetoprotein for placenta accrete revealed that the
area under curve (AUC) was 0.958 and the best cutoff was > 0.84 MoM with a sensitivity of 92%, specificity
= 82% PPV = 83%, NPV = 87.2% and accuracy of 85% (p<0.01).
Conclusion: In conclusion, the results indicate a significant association between elevated serum alphafetoprotein
level and placenta accreta. Also, serum alpha-fetoprotein has a high predictive value for placenta
accreta in women with complete placenta previa centeralis.
