Your browser doesn't support javascript.
loading
Placental growth factor as a marker of fetal growth restriction caused by placental dysfunction.
Benton, Samantha J; McCowan, Lesley M; Heazell, Alexander E P; Grynspan, David; Hutcheon, Jennifer A; Senger, Christof; Burke, Orlaith; Chan, Yuen; Harding, Jane E; Yockell-Lelièvre, Julien; Hu, Yuxiang; Chappell, Lucy C; Griffin, Melanie J; Shennan, Andrew H; Magee, Laura A; Gruslin, Andrée; von Dadelszen, Peter.
Afiliación
  • Benton SJ; Department of Obstetrics and Gynaecology, Faculty of Medicine, University of British Columbia, 4500 Oak Street, Vancouver, British Columbia, V6H 3N1, Canada. Electronic address: sbenton@uottawa.ca.
  • McCowan LM; Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand. Electronic address: l.mccowan@auckland.ac.nz.
  • Heazell AE; Maternal and Fetal Health Research Centre, University of Manchester, 5th Floor, St. Mary's Hospital, Oxford Road, Manchester, M13 9WL, United Kingdom. Electronic address: Alexander.Heazell@manchester.ac.uk.
  • Grynspan D; Department of Pathology, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, Ontario, K1H 8L1, Canada. Electronic address: dgrynspan@cheo.on.ca.
  • Hutcheon JA; Department of Obstetrics and Gynaecology, Faculty of Medicine, University of British Columbia, 4500 Oak Street, Vancouver, British Columbia, V6H 3N1, Canada. Electronic address: jhutcheon@cfri.ca.
  • Senger C; Department of Pathology, Children's and Women's Health Centre of British Columbia, 4500 Oak Street, Vancouver, British Columbia, V6H 2N9, Canada. Electronic address: csenger@cw.bc.ca.
  • Burke O; Nuffield Department of Population Health, Institute of Health Sciences, University of Oxford, Old Road, Oxford, OX3 7LF, United Kingdom. Electronic address: orlaith.burke@ndph.ox.ac.uk.
  • Chan Y; Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand. Electronic address: Yuen.Chan@monashhealth.org.
  • Harding JE; Liggins Institute, University of Auckland, Private Bag 92019, Victoria Street West, Auckland, 1142, New Zealand. Electronic address: j.harding@auckland.ac.nz.
  • Yockell-Lelièvre J; Sprott Centre for Stem Cell Research, Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, Ontario, K1H 8L6, Canada. Electronic address: jyockell@ohri.ca.
  • Hu Y; Department of Obstetrics and Gynaecology, Faculty of Medicine, University of British Columbia, 4500 Oak Street, Vancouver, British Columbia, V6H 3N1, Canada. Electronic address: yhu@cw.bc.ca.
  • Chappell LC; Women's Health Academic Centre, King's College London, 10th Floor North Wing, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, United Kingdom. Electronic address: lucy.chappell@kcl.ac.uk.
  • Griffin MJ; Women's Health Academic Centre, King's College London, 10th Floor North Wing, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, United Kingdom. Electronic address: melanie.griffin@kcl.ac.uk.
  • Shennan AH; Women's Health Academic Centre, King's College London, 10th Floor North Wing, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, United Kingdom. Electronic address: andrew.shennan@kcl.ac.uk.
  • Magee LA; Department of Obstetrics and Gynaecology, Faculty of Medicine, University of British Columbia, 4500 Oak Street, Vancouver, British Columbia, V6H 3N1, Canada. Electronic address: LMagee@sgul.ac.uk.
  • Gruslin A; Department of Obstetrics and Gynaecology, University of Ottawa, 501 Smyth Road, Ottawa, Ontario, K1H 8L6, Canada.
  • von Dadelszen P; Department of Obstetrics and Gynaecology, Faculty of Medicine, University of British Columbia, 4500 Oak Street, Vancouver, British Columbia, V6H 3N1, Canada. Electronic address: pvondade@sgul.ac.uk.
Placenta ; 42: 1-8, 2016 06.
Article en En | MEDLINE | ID: mdl-27238707
INTRODUCTION: Discriminating between placentally-mediated fetal growth restriction and constitutionally-small fetuses is a challenge in obstetric practice. Placental growth factor (PlGF), measurable in the maternal circulation, may have this discriminatory capacity. METHODS: Plasma PlGF was measured in women presenting with suspected fetal growth restriction (FGR; ultrasound fetal abdominal circumference <10th percentile for gestational age) at sites in Canada, New Zealand and the United Kingdom. When available, placenta tissue underwent histopathological examination for lesions indicating placental dysfunction, blinded to PlGF and clinical outcome. Lesions were evaluated according to pre-specified severity criteria and an overall severity grade was assigned (0-3, absent to severe). Low PlGF (concentration <5th percentile for gestational age) to identify placental FGR (severity grade≥2) was assessed and compared with routine parameters for fetal assessment. For all cases, the relationship between PlGF and the sampling-to-delivery interval was determined. RESULTS: Low PlGF identified placental FGR with an area under the receiver-operator characteristic curve of 0.96 [95% CI 0.93-0.98], 98.2% [95% CI 90.5-99.9] sensitivity and 75.1% [95% CI 67.6-81.7] specificity. Negative and positive predictive values were 99.2% [95% CI 95.4-99.9] and 58.5% [95% CI 47.9-68.6], respectively. Low PlGF outperformed gestational age, abdominal circumference and umbilical artery resistance index in predicting placental FGR. Very low PlGF (<12 pg/mL) was associated with shorter sampling-to-delivery intervals than normal PlGF (13 vs. 29.5 days, P < 0.0001). DISCUSSION: Low PlGF identifies small fetuses with significant underlying placental pathology and is a promising tool for antenatal discrimination of FGR from fetuses who are constitutionally-small.
Asunto(s)
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Placenta / Insuficiencia Placentaria / Retardo del Crecimiento Fetal / Factor de Crecimiento Placentario Tipo de estudio: Diagnostic_studies / Etiology_studies / Prognostic_studies Límite: Adult / Female / Humans / Pregnancy Idioma: En Revista: Placenta Año: 2016 Tipo del documento: Article Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Placenta / Insuficiencia Placentaria / Retardo del Crecimiento Fetal / Factor de Crecimiento Placentario Tipo de estudio: Diagnostic_studies / Etiology_studies / Prognostic_studies Límite: Adult / Female / Humans / Pregnancy Idioma: En Revista: Placenta Año: 2016 Tipo del documento: Article Pais de publicación: Países Bajos