Increased level of cell-free placental mRNA in a subgroup of placenta previa that needs hysterectomy.

OBJECTIVE

The purpose of this study was to investigate whether cell-free placental mRNA levels have the potential to predict a placenta previa resulting in hysterectomy.

METHODS

Twenty-eight singleton pregnant women with placenta previa were classified into the following four groups: 16 women with placenta located at a posterior part of the uterine wall (Group A); 4 each with placenta located at the anterior wall without (Group B) or with (Group C) previous cesarean section; and the other 4 with a history of previous cesarean section and who had the placenta located at an anterior part of uterine wall and underwent a cesarean hysterectomy (Group D). The maternal plasma concentrations of the cell-free placental lactogen (PL) mRNA measured by real-time reverse-transcription polymerase chain reaction (PCR) were converted into multiples of the median (MoM).

RESULTS

The MoM (range) values of cell-free PL mRNA in the control group and Groups A to D were 1.00 (0.39-2.35), 2.04 (0.91-3.93), 2.58 (1.90-3.90), 3.50 (1.20-4.30), and 6.28 (5.24-7.63), respectively. The concentration of cell-free PL mRNA was significantly higher in Group D than in Group A, B, or C (Mann-Whitney's U-test, P < 0.05).

CONCLUSION

The cell-free PL mRNA concentration in maternal plasma has the potential to predict a subgroup of placenta accreta resulting in hysterectomy.