Ruge S, Pedersen J F, Sørensen S, Lange A P
Department of Gynaecology and Obstetrics, Glostrup Hospital, University of Copenhagen, Denmark.
Acta Obstet Gynecol Scand. 1990;69(7-8):589-95. doi: 10.3109/00016349009028701.
Depressed pregnancy-associated plasma protein A (PAPP-A) concentrations have been found in patients with threatened abortion, often weeks before spontaneous abortion while the fetus was still alive. In order to extend these findings we have developed a highly sensitive PAPP-A radio-immunoassay and have established a reference range in early pregnancy for PAPP-A between week 7 and week 20 of pregnancy, based on blood samples from 240 pregnant women. The gestational age was determined by ultrasound. PAPP-A was measured in 128 women admitted to hospital because of vaginal bleeding in the 7th to 20th gestational week. The viability of the fetus was confirmed by ultrasonography. The serum values of PAPP-A were significantly lower (p = 0.002) in the group of women with vaginal bleeding than in the group of normally pregnant women. However, with regard to abortion later on, the predictive value of an abnormal blood test on admission was only 18.7%. Serial determinations showed increased PAPP-A values corresponding to the centile expected in the 12 women who aborted, as well as in the 116 women who gave birth. Consequently, the test is of no clinical value in the assessment of the prognosis in patients with symptoms of threatened abortion.
在先兆流产患者中发现妊娠相关血浆蛋白A（PAPP-A）浓度降低，通常在自然流产前数周，此时胎儿仍然存活。为了扩展这些发现，我们开发了一种高度灵敏的PAPP-A放射免疫测定法，并基于240名孕妇的血样，建立了妊娠第7周至第20周早期妊娠PAPP-A的参考范围。通过超声确定孕周。对128名在妊娠第7周至第20周因阴道出血入院的妇女进行了PAPP-A检测。通过超声检查确认胎儿的存活情况。阴道出血组妇女的PAPP-A血清值显著低于正常妊娠组（p = 0.002）。然而，关于随后的流产情况，入院时血液检测异常的预测价值仅为18.7%。连续测定显示，在12名流产妇女以及116名分娩妇女中，PAPP-A值升高至相应的百分位数。因此，该检测在评估先兆流产症状患者的预后方面没有临床价值。
