Maternal Serum PAPP - A Level in Early Pregnancy as a Screening Test for Prediction of Pre-Eclampsa

Background and aim: Preeclampsia remains a major problem of modern obstetrics with insufficiently elucidated etiology. Early detection would diminish maternal and fetal mortality and morbidity. Pre eclampsia is a multi system disorder and develops typically after 20 weeks of gestation with proteinuria in previously normotensive and non proteinuric women. Incidence of hypertensive disorders contributes to 9% of maternal mortality in Asia and 12% in India. Preeclampsia is associated with reduced production of the PAPP-A and several studies have reported that during the clinical phase of PE the maternal serum PAPP-A concentration is reduced. Aim: The aim of this study is to determine the serum values of PAPPA-A in the first trimester of pregnancy and subsequently with risk factor for preeclampsia. In order to evaluate their relevance in the predictor of preeclampsia. This study is to investigate the prognostic value of abnormal serum PAPPA-A as predictor of preeclampsia. Methods: It is a prospective randomized observational study in Pregnant woman in first trimester coming to regular Antenaal OPD in the Department of Obstetrics and gynecology, government Rajaji Hospital attached to Madurai Medical College, Madurai for the period is 8months. The study is conducted on 200 cases. The study subjects will be followed up till delivery for each visit pt advised to check BP, urine albumin and watch for development of preeclampsia. Results: In our study, most of the patients were between the age group of 20 to 35years.There is significant difference between development of preeclampsia in a women with decreased levels of serum PAPP-A compared with elevated levels of PAPP-A. Conclusion: In our study there is significant independent contribution from maternal serum PAPP-A which was found to be decreased in screening of PE women compared to normotensive pregnant women. Early prediction of Preeclampsia could potentially improve the outcome by close surveillance of the patient and would be the basis of the prophylactic medications, starting from the first trimester to improve placental invasion, uteroplacental circulation and so decreasing the prevalence of the disease.