Importance of Research Results

Oct 13, 2025 by wbrum.org 20 views

Differences in Serum Alpha-Fetoprotein (AFP) Levels in Pregnancy with Placenta Accreta Spectrum (PAS) Abnormalities Compared to Normal Pregnancy

Introduction

Placenta Accreta Spectrum (PAS) is a disorder associated with abnormal placental attachment, which has become a significant concern in obstetrics. The increased prevalence of PAS is associated with an increase in cesarean delivery rates and the presence of previa placenta. Pregnant women at high risk require hysterectomy, increasing the morbidity and mortality of mothers. Early detection and management of PAS are crucial to reduce the risk of serious complications for the mother and fetus. Alpha-fetoprotein (AFP) is a biomarker and serum glycoprotein produced by the egg yolk and liver of the fetus. Increased levels of maternal serum AFP during the second and third trimester of pregnancy are associated with poor pregnancy outcomes. This study aims to determine the difference in serum AFP levels in pregnancy with PAS abnormalities compared to normal pregnancy.

Methodology

This observational analytic research with a case-control design was conducted in the Department of Obstetrics and Gynecology H. Adam Malik Medan Hospital and Medan RSU from March 2020 to November 2020. The study consisted of two groups: a case group (n = 15) and a control group (n = 15). The case group consisted of third-trimester pregnant women with a high risk of PAS, as determined by ultrasound and histopathology, and meeting the inclusion and exclusion criteria. The control group consisted of third-trimester pregnant women without a high risk of PAS, single pregnancy, without gynecological disease or malignancy, special diseases of the liver, and congenital abnormalities. Blood samples were sent to the clinical laboratory of H. Adam Malik Hospital Medan. This study has received approval from the Ethics Committee of the Faculty of Medicine, University of North Sumatra. Data analysis was performed using Windows SPSS computer program version 22.0.

Results

The results showed a significant difference in serum AFP levels between the case and control groups. The mean serum AFP levels in the case group were 249.51 ng/ml ± 90.86 (2.22 ± 0.81 Mom), while the control group had a mean serum AFP level of 120.5 ng/ml ± 49.95 (1.07 ± 0.44 Mom) with a p-value <0.001. The average serum AFP levels in the PAS1 group were 230 ng/ml ± 26.68, and in the PAS2 group, they were 258.98 ng/ml ± 10.58. The average serum AFP content in the placenta accreta group was 248.70 ng/ml ± 95.66, the placenta inkreta group was 220.63 ng/ml ± 69.78, and the placental percreta group was 373.08 ng/ml.

Discussion

The results of this study show that there are significant differences in AFP levels in pregnancy with PAS abnormalities compared to normal pregnancy. Increased levels of AFP are proportional to the severity of PAS abnormalities based on USG criteria and histopathological features. This finding suggests that serum AFP levels can be a potential marker to detect the existence and severity of PAS. Increased AFP levels are most likely due to increased permeability of blood vessels and increased blood flow in the placenta that occurs in PAS. In addition, the possibility is also caused by an increase in AFP production by stressful fetal cells due to abnormal placental attachment.

Limitations

This study has several limitations, including a small sample size and only being conducted in two hospitals in Medan. Further research with a larger number of samples and involving various hospitals in Indonesia is needed to confirm this finding and explore the role of AFP as a diagnostic marker for PAS.

Importance of Research Results

The results of this study provide important information for obstetricians and obstetric experts in diagnosing PAS. Increasing awareness of the importance of monitoring serum AFP levels in pregnant women with a high risk of PAS can help detect and manage this condition more effectively. Early detection is very important to reduce the risk of serious complications for the mother and fetus.

Recommendation

Further research with a larger number of samples and involving various hospitals in Indonesia is necessary to validate these findings.
Research is necessary to examine the role of AFP as a diagnostic marker for PAS.
Education is necessary for obstetricians and obstetric experts about the importance of monitoring serum AFP levels in pregnant women with a high risk of PAS.
Counseling is necessary for the public about PAS and the importance of early detection.

Conclusion

In conclusion, this study found significant differences in serum AFP levels in pregnancy with PAS abnormalities compared to normal pregnancy. Increased levels of AFP are proportional to the severity of PAS abnormalities based on USG criteria and histopathological features. This finding suggests that serum AFP levels can be a potential marker to detect the existence and severity of PAS. Further research is necessary to confirm this finding and explore the role of AFP as a diagnostic marker for PAS.

Keywords

Placenta Accreta Spectrum (PAS)
Alpha-Fetoprotein (AFP)
Pregnancy
Ultrasound
Histopathology
Frequently Asked Questions (FAQs) about Placenta Accreta Spectrum (PAS) and Alpha-Fetoprotein (AFP)

Q: What is Placenta Accreta Spectrum (PAS)?

A: Placenta Accreta Spectrum (PAS) is a disorder associated with abnormal placental attachment. It occurs when the placenta grows too deeply into the uterine wall, which can cause serious complications for the mother and fetus.

Q: What are the symptoms of PAS?

A: The symptoms of PAS can vary depending on the severity of the condition. Some common symptoms include:

Severe abdominal pain
Vaginal bleeding
Fetal distress
Preterm labor

Q: What is Alpha-Fetoprotein (AFP)?

A: Alpha-Fetoprotein (AFP) is a biomarker and serum glycoprotein produced by the egg yolk and liver of the fetus. It is used as a screening test for fetal abnormalities and can also be used to detect the presence of PAS.

Q: How is AFP tested?

A: AFP is typically tested through a blood sample, which is sent to a laboratory for analysis. The results are usually available within a few days.

Q: What are the risks associated with PAS?

A: The risks associated with PAS include:

Severe bleeding
Fetal distress
Preterm labor
Hysterectomy (removal of the uterus)
Increased risk of maternal and fetal mortality

Q: Can PAS be treated?

A: While there is no cure for PAS, treatment options are available to manage the condition. These may include:

Bed rest
Medication to control bleeding
Surgery to remove the placenta
Hysterectomy (removal of the uterus)

Q: How can PAS be prevented?

A: While there is no guaranteed way to prevent PAS, some risk factors can be reduced or eliminated, such as:

Avoiding multiple pregnancies
Avoiding previous uterine surgery
Avoiding previous uterine trauma
Maintaining a healthy pregnancy

Q: What is the role of AFP in detecting PAS?

A: AFP can be used as a potential marker to detect the existence and severity of PAS. Increased levels of AFP are proportional to the severity of PAS abnormalities based on USG criteria and histopathological features.

Q: Can AFP be used as a diagnostic marker for PAS?

A: While AFP can be used as a potential marker for PAS, it is not a definitive diagnostic marker. Further research is necessary to confirm the role of AFP as a diagnostic marker for PAS.

Q: What are the limitations of this study?

A: This study has several limitations, including a small sample size and only being conducted in two hospitals in Medan. Further research with a larger number of samples and involving various hospitals in Indonesia is necessary to confirm this finding and explore the role of AFP as a diagnostic marker for PAS.

Q: What are the implications of this study?

A: The results of this study provide important information for obstetricians and obstetric experts in diagnosing PAS. Increasing awareness of the importance of monitoring serum AFP levels in pregnant women with a high risk of PAS can help detect and manage this condition more effectively. Early detection is very important to reduce the risk of serious complications for the mother and fetus.

Q: What are the recommendations for further research?

A: Further research with a larger number of samples and involving various hospitals in Indonesia is necessary to validate these findings and explore the role of AFP as a diagnostic marker for PAS. Education is necessary for obstetricians and obstetric experts about the importance of monitoring serum AFP levels in pregnant women with a high risk of PAS. Counseling is necessary for the public about PAS and the importance of early detection.