Maternal Serum Alpha Fetoprotein Versus Ultrasound Criteria in Prediction of Outcome in Pregnancies with Suspected Morbid Adherence of the Placenta
/ 0
- Details
- Category: Vol. 82, December 2014
- Hits: 622
Maternal Serum Alpha Fetoprotein Versus Ultrasound Criteria in Prediction of Outcome in Pregnancies with Suspected Morbid Adherence of the Placenta, MOSTAFA F. GOMAA, AHMED E. ALBEHOUTY, AMGAD S. ABU GAMRA, HESHAM M. FATHY and MAHMOUD GHALEB
Abstract
Purpose: The study aimed at comparing unexplained elevated maternal serum AFP and ultrasound criteria in pre-dicting the maternal outcome at delivery in patients with suspected morbid placental adherence.
Methods: The study was a prospective cohort study carried out at Ain Shams University Maternity Hospital. 60 pregnant women with suspected morbidly adherent placenta by trans-abdominal ultrasound had their maternal serum alpha-fetoprotein (MSAFP) levels measured. Women for with other causes for MSAFP elevation were excluded. Statistical analysis was performed by chi-square test, Fisher’s exact test, Student’s t-test, and odds ratio calculation.
Results: In our study a sonographic score >!3 was associated with morbid adherence at a sensitivity of 82.6%, specificity of 92.1%, positive predictive value [PPV] of 97.4%, negative predictive value [NPV] of 61.9%, positive likelihood ratio [LR+] of 11.6, and a negative likelihood ratio [LR–] of 0.2, while a MSAFP >2MOM was associated with morbid adher-ence of placenta at a sensitivity of 93.3%, specificity of 71.4%, PPV of 91.3%, NPV of 71.4%, LR+ of 3.2, and LR– of 0.1. Moreover we found that MSAFP >2MOM was associated with 3-fold, 7-fold, 2-fold, and 3-fold increase in intra-operative placental adherence, bladder injury, postpartum hemorrhage and caesarian hysterectomy respectively.
Conclusion: An unexplained elevated MSAFP level >2MoM, which is an objective method can be a more useful method in predicting intra-operative morbid placental adher-ence and intra-operative complications in cases of suspected morbidly adherent placenta.