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| The value of maternal serum alphafetoprotein level combined with imaging for diagnosing of placenta previa and placental accrete |
| 1. Taizhou People's Hospital, Jiangsu Province, 225700; 2. Dalian Medical University; 3. Clinical Medical College of Yangzhou University |
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Abstract Objective: To explore the value of maternal serum levels of alphafetoprotein (AFP) and creatine kinase (CK) measurement combined with imaging for diagnosing of placenta previa and placental accrete. Methods: 80 pregnant women with single pregnancy and placenta previa who had delivered by cesarean section were selected as study subjects from October 2016 to March 2018. According to the intraoperative findings and postoperative histopathology results, these women were divided into group A (36 women with placenta implantation), group B (44 women out placenta implantation). And another 54 pregnant women with single pregnancy who had high risk factors for placenta previa and delivered by cesarean section were selected in group C. The level of maternal serum AFP of women during the second trimester of pregnancy and the levels of maternal serum AFP and CK of women during the third trimester of pregnancy, and the results by color Doppler ultrasound and magnetic resonance imaging (MRI) were compared among the three groups. Results: The AFP level of women in group A during the second and third trimester of pregnancy was significant higher than that of women in group B and C (P<0.05). There was no statistically significant difference in CK level during the third trimester of pregnancy of women among the three groups (P>0.05). According to ROC curve analysis, the critical value of AFP level during the second and the third trimester of pregnancy for diagnosing placenta praevia were 55.1ug/L and 276.5ug/L, which’s area under the curve, was 0.75 and 0.81. The value of AFP level during the third trimester of pregnancy for diagnosing placenta praevia and placental implantation was slightly higher than that of AFP level during the second trimester of pregnancy. The diagnostic sensitivity and specificity of AFP level combined with color Doppler ultrasound and MRI during the second and third trimester of pregnancy were 94.4% and 88.6%, which were all significant higher than those of diagnosed by AFP level, color Doppler ultrasound, or MRI only. Conclusion: The detection of maternal serum AFP level during the second and third trimester of pregnancy has certain significance for the diagnosing placenta previa and placenta accrete. The combination of imaging and serum AFP level can improve the diagnostic sensitivity and specificity, which is superior to diagnose by AFP level, color Doppler ultrasound, or MRI only, so it is has certain diagnostic value.
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