Maternal plasma levels of cell-free β-HCG mRNA as a prenatal diagnostic indicator of placenta accrete

• Published in: Placenta (Eastbourne) Vol. 35; no. 9; pp. 691 - 695
• Main Authors: Zhou, J, Li, J, Yan, P, Ye, Y.H, Peng, W, Wang, S, Wang, X. Tong
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01-09-2014; Elsevier
• Subjects: Adult; Biological and medical sciences; Biomarkers - blood; Case-Control Studies; Cell-free placenta mRNA; Chorionic Gonadotropin, beta Subunit, Human - metabolism; Embryology: invertebrates and vertebrates. Teratology; Female; Fundamental and applied biological sciences. Psychology; Humans; Internal Medicine; Magnetic Resonance Imaging; Obstetrics and Gynecology; Placenta - metabolism; Placenta accreta; Placenta Accreta - blood; Placenta Accreta - diagnostic imaging; Placenta Previa - blood; Placentation; Pregnancy; Prenatal diagnosis; Real-Time Polymerase Chain Reaction; RNA, Messenger - blood; Ultrasonography; β-HCG; Placenta accreta; β-HCG; Prenatal diagnosis; Cell-free placenta mRNA; Fetal membrane; Langerhans islet; Gonadotropin; Plasmocyte; Placental hormone; Indicator; Prenatal; Human chorionic gonadotrophin; Vertebrata; Mammalia; Placenta; Messenger RNA; Mother; β Cell; Diagnosis; Endocrine pancreas
• ISSN: 0143-4004; 1532-3102
• DOI: 10.1016/j.placenta.2014.07.007

Abstract Objective Several biomarkers, including maternal serum creatinine kinase and α-fetoprotein, have been described as potential tools for the diagnosis of placental abnormalities. This study aimed to determine whether maternal plasma mRNA levels of the β subunit of human chorionic gonadotropin (β-HCG) could predict placenta accreta prenatally. Methods Sixty-eight singleton pregnant women with prior cesarean deliveries (CDs) were classified into three groups: normal placentation (35 women, control group); placenta previa alone (21 women, placenta previa group); and both placenta previa and placenta accreta (12 women, placenta previa/accreta group). Maternal plasma concentrations of cell-free β-HCG mRNA were measured by real-time reverse-transcription polymerase chain reaction and were expressed as multiples of the median (MoM). Results Cell-free β-HCG mRNA concentrations (MoM, range) were significantly higher in women with placenta accreta (3.65, 2.78–7.19) than in women with placenta previa (0.94, 0.00–2.97) or normal placentation (1.00, 0.00–2.69) (Steel–Dwass test, P  < 0.01 and P  < 0.01, respectively). In the placenta previa/accreta group, the concentration of cell-free β-HCG mRNA was significantly higher among women who underwent CDs with hysterectomy (4.41, 3.49–7.19) than among women whose CDs did not result in hysterectomy (3.20, 2.78–3.70) (Mann–Whitney U test, P  = 0.012). Discussion An increased level of cell-free β-HCG mRNA in the maternal plasma of women with placenta accreta may arise from direct uteroplacental transfer of cell-free placental mRNA molecules. Conclusions The concentration of cell-free β-HCG mRNA in maternal plasma may be applicable to the prenatal diagnosis of placenta accreta, especially to identify women with placenta accreta likely to require hysterectomy.