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Clinical and Experimental Obstetrics & Gynecology  2015, Vol. 42 Issue (5): 617-618    DOI: 10.12891/ceog1917.2015
Original Research Previous articles | Next articles
Pregnancy-associated plasma protein a levels are decreased in obstetric cholestasis
N. Hancerlioğullari1, *(), A. Aktulay1, Y. Engin-Ustun1, M.Ş. Ozkan1, A. Oksuzoglu1, N. Danişman1
1Zekai Tahir Burak Woman's Health Education and Research Hospital, Gynecology and Obstetrics Department, Ankara (Turkey)
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Objective: Obstetric cholestasis is a cholestatic disease usually commencing in the third trimester of pregnancy and characterized by pruritus, elevation of liver enzymes, and increase in bile acids. The objective of this study was to compare the first trimester serum indicators of obstetric cholestasis with normal pregnancies. Materials and Methods: Thirty-five patients diagnosed with obstetric cholestasis in a three-year period with first trimester biochemical assessment available were included in the study. Seventy patients with concordant pregnancy weeks, matched-age normal pregnancies were included as the control group. Pregnancy-associated plasma protein A (PAPP-A) and free beta-human chorionic gonadotropin (beta-hCG) levels were analyzed. Results: No difference was observed between the two groups in terms of age and week of pregnancy. While the mean PAPP-A level was 0.76 ± 0.31 multiples of the medians (MoM) in the obstetric cholestasis group, it was determined to be 1.5 ± 0.84 in the control group (p = 0.0001). Among the two groups, the hCG levels were found to be higher in the obstetric cholestasis group (1.2 ± 0.79 MoM vs. 0.98 ± 0.53, p = 0.041). Conclusion: In this study, the first trimester PAPP-A levels in the obstetric cholestasis cases were found to be significantly lower than the control group. Low PAPP-A levels should be a warning for obstetric cholestasis.
Key words:  Obstetric cholestasis      Pregnancy-associated plasma protein A     
Published:  10 October 2015     
*Corresponding Author(s):  N. HANCERLIOĞULLARI     E-mail:

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N. Hancerlioğullari, A. Aktulay, Y. Engin-Ustun, M.Ş. Ozkan, A. Oksuzoglu, N. Danişman. Pregnancy-associated plasma protein a levels are decreased in obstetric cholestasis. Clinical and Experimental Obstetrics & Gynecology, 2015, 42(5): 617-618.

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