Journal of Isfahan Medical School

Journal of Isfahan Medical School

The Role of Soluble fms-Like Tyrosine Kinase-1 Markers and Vascular Endothelial Growth Factor in Comparison with Color Doppler Sonography for Detecting Plasenta Accreta

Document Type : Original Article (s)

Authors
Elhan Naghshineh 1
Faranak Razaghi 2
1 Associate Professor, Department of Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Resident, Department of Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
10.22122/jims.v37i518.11355
Abstract
Background: Regarding the relatively high prevalence of placenta accreta in pregnancy, and the lack of suitable methods for predicting this complication, this study aimed to determine the role of soluble fms-like tyrosine kinase-1 (SFLT-1) markers and vascular endothelial growth factor (VEGF) in comparison with color Doppler sonography in diagnosis of placenta accreta.Methods: In a cross-sectional study, 78 pregnant women who were referred to Alzahra and Shahid Beheshti hospitals in Isfahan, Iran, in 2017 and 2018 were studied. SFLT-1 and VEGF levels were measured, and embryo sonography was also performed. After surgery, the results of surgery were compared with the results of sonography, and the level of SFLT-1 and VEGF and the agreement of these markers with ultrasound were determined.Findings: There was no significant difference in mean VEGF level in terms of pregnancy outcomes (P = 0.90), but SFLT-1 level was significantly lower in Eckert group (P = 0.02). Meanwhile, SFLT-1/VEGT ratio was not different between the two groups (P = 0.66). Comparison of ultrasound findings and surgical results showed that surgical outcomes and ultrasonography were normal in 38 cases (48.7%). Moreover, in 16 cases (20.5%), the results of surgery and ultrasound showed the presence of plementa acrata. The agreement between ultrasonography and surgery was 0.36 (P < 0.001).Conclusion: According to the results of our study, the two markers SFLT-1 and VEGF, compared with ultrasound, were not suitable criteria for predicting placenta accreta. At the same time, according to the limitations of this study, further studies are suggested.
Keywords
Angiogenic peptides
Placenta accreta
Vascular endothelial growth factor
fms-like tyrosine kinase
  1. Venkatesan T, Alaseem A, Chinnaiyan A, Dhandayuthapani S, Kanagasabai T, Alhazzani K, et al. MDM2 overexpression modulates the angiogenesis-related gene expression profile of prostate cancer cells. Cells 2018; 7(5).
  2. Belfort MA, Shamshirsaz AA, Fox KA. The diagnosis and management of morbidly adherent placenta. Semin Perinatol 2018; 42(1): 49-58.
  3. Jauniaux E, Collins S, Burton GJ. Placenta accreta spectrum: Pathophysiology and evidence-based anatomy for prenatal ultrasound imaging. Am J Obstet Gynecol 2018; 218(1): 75-87.
  4. Shin JY, Ji JO, Choi DW, Choi SH, Choi JG, Rho MS, et al. Expression of genes in primo vasculature floating in lymphatic endothelium under lipopolysaccharide and acupuncture electric stimulation. J Acupunct Meridian Stud 2019; 12(1): 3-10.
  5. Failla CM, Carbo M, Morea V. Positive and negative regulation of angiogenesis by soluble vascular endothelial growth factor receptor-1. Int J Mol Sci 2018; 19(5): E1306.
  6. Mesquita J, Castro-de-Sousa JP, Vaz-Pereira S, Neves A, Passarinha LA, Tomaz CT. Vascular endothelial growth factors and placenta growth factor in retinal vasculopathies: Current research and future perspectives. Cytokine Growth Factor Rev 2018; 39: 102-15.
  7. Rajakumar A, Cerdeira AS, Rana S, Zsengeller Z, Edmunds L, Jeyabalan A, et al. Transcriptionally active syncytial aggregates in the maternal circulation may contribute to circulating soluble fms-like tyrosine kinase 1 in preeclampsia. Hypertension 2012; 59(2): 256-64.
  8. Wolf M, Hubel CA, Lam C, Sampson M, Ecker JL, Ness RB, et al. Preeclampsia and future cardiovascular disease: Potential role of altered angiogenesis and insulin resistance. J Clin Endocrinol Metab 2004; 89(12): 6239-43.
  9. Powe CE, Levine RJ, Karumanchi SA. Preeclampsia, a disease of the maternal endothelium: The role of antiangiogenic factors and implications for later cardiovascular disease. Circulation 2011; 123(24): 2856-69.
  10. Levine RJ, Maynard SE, Qian C, Lim KH, England LJ, Yu KF, et al. Circulating angiogenic factors and the risk of preeclampsia. N Engl J Med 2004; 350(7): 672-83.
  11. Ferrara N, Gerber HP, LeCouter J. The biology of VEGF and its receptors. Nat Med 2003; 9(6): 669-76.
  12. Ahmed A, Dunk C, Ahmad S, Khaliq A. Regulation of placental vascular endothelial growth factor (VEGF) and placenta growth factor (PIGF) and soluble Flt-1 by oxygen--a review. Placenta 2000; 21(Suppl A): S16-S24.
  13. Naghshineh E, Khorvash E, Kamali S. A comparison of cell-free placental messenger ribonucleic acid and color Doppler ultrasound for the prediction of placental invasion in patients with placenta accreta. Adv Biomed Res 2015; 4: 31.
  14. Andraweera PH, Dekker GA, Roberts CT. The vascular endothelial growth factor family in adverse pregnancy outcomes. Hum Reprod Update 2012; 18(4): 436-57.
  15. Usta IM, Hobeika EM, Musa AA, Gabriel GE, Nassar AH. Placenta previa-accreta: risk factors and complications. Am J Obstet Gynecol 2005; 193(3 Pt 2): 1045-9.
  16. McMahon K, Karumanchi SA, Stillman IE, Cummings P, Patton D, Easterling T. Does soluble fms-like tyrosine kinase-1 regulate placental invasion? Insight from the invasive placenta. Am J Obstet Gynecol 2014; 210(1): 68-4.
  17. Tseng JJ, Chou MM, Hsieh YT, Wen MC, Ho ES, Hsu SL. Differential expression of vascular endothelial growth factor, placenta growth factor and their receptors in placentae from pregnancies complicated by placenta accreta. Placenta 2006; 27(1): 70-8.
  18. Kleinrouweler CE, Wiegerinck MM, Ris-Stalpers C, Bossuyt PM, van der Post JA, von Dadelszen P, et al. Accuracy of circulating placental growth factor, vascular endothelial growth factor, soluble fms-like tyrosine kinase 1 and soluble endoglin in the prediction of pre-eclampsia: A systematic review and meta-analysis. BJOG 2012; 119(7): 778-87.
  19. Shih JC, Palacios Jaraquemada JM, Su YN, Shyu MK, Lin CH, Lin SY, et al. Role of three-dimensional power Doppler in the antenatal diagnosis of placenta accreta: Comparison with gray-scale and color Doppler techniques. Ultrasound Obstet Gynecol 2009; 33(2): 193-203.
  20. Krapp M, Baschat AA, Hankeln M, Gembruch U. Gray scale and color Doppler sonography in the third stage of labor for early detection of failed placental separation. Ultrasound Obstet Gynecol 2000; 15(2): 138-42.
  21. Halpern EJ, Strup SE. Using gray-scale and color and power Doppler sonography to detect prostatic cancer. AJR Am J Roentgenol 2000; 174(3): 623-7.
  22. Chou MM, Tseng JJ, Ho ES. Usefulness of gray-scale ultrasound and complementary color Doppler ultrasound in the prenatal diagnosis of placenta previa accreta. Am J Obstet Gynecol 2005; 192(4): 1349.
Journal of Isfahan Medical School
Volume 37, Issue 518 - Serial Number 518
January and February 2019
Pages 176-181

  • Receive Date 12 February 2019
  • Accept Date 06 April 2022