MATERNAL PLASMA BIOMARKERS (ANTITHROMBIN 3, PLASMOINOGEN ACTIVATOR INHIBITOR 1, SOLUBLE TIE 2, VASCULАR ENDOTHELIAL GROWTH FACTOR RECEPTOR2) AS INDICATORS FOR PLACENTA ACCRETA SPECTRUM (PAS) IN THE THIRD TRIMESTER OF PREGNANCY

Abstract

Introduction: Placenta accreta spectrum (PAS)- an abnormally adherent placenta into the uterine wall with the inability to properly detach after the birth of the fetus. Factors that increase the risk of PAS are: regions of poorly developed decidua, previous caesarean section/s, etc. Materials and Methods: This study is a prospective cohort study conducted at The University Clinic of Gynecology and Obstetrics Skopje, Republic of North Macedonia in February and March 2021. The study involved 8 patients, diagnosed with PAS, from whom maternal plasma samples were taken. Measurements of concentration of antithrombin III, plasminogen activator inhibitor 1(PAI1), soluble Tie 2 (sol Tie2), vascular endothelial growth factor receptor 2(VEGFR2), in the third trimester of pregnancy were done. Results: In all 8 patients, a PAS diagnosis was detected. In previous ultrasound findings, placenta praevia was diagnosed in 4 of 8 patients, and the remaining 4 had ultrasound signs for placenta accreta. In terms of biomarker values, we received significant values in all 4 biomarkers we examined. Conclusion: The examination of these biomarkers is useful for predicting and early diagnosis of PAS. We confirmed antithrombin III, PAI-1, soluble Tie2 and soluble VEGF 2 receptor as new biomarkers for this condition.