Searching for a Cheap Marker for Placenta Accreta Spectrum in a Low Resource Country: A Prospective Cohort Study

Abstract

Objective: To assess maternal serum amyloid A (SAA) levels among women with Placenta Accreta spectrum. Methods: We performed a prospective observational cohort study among women with Placenta Accreta Spectrum at Ain Shams University Maternity Hospital, Cairo, Egypt, between March 2017 and August 2017. The study group included women with a previous CS and diagnosed with placenta previa or accreta (20 patients in each group), while the control group included twenty women with a normally situated placenta. We collected Serum samples to measure SAA levels at the time of admission. The primary outcome was the association between SAA and the Placenta Accreta Spectrum. SAA levels were compared using the ANOVA test. We also performed Receiver Operating Characteristics characteristic analysis for previa/accrete versus normal and previa versus accreta.Results : Each group contained 20 participants with comparable baseline characteristics. The Maternal serum amyloid-A level was 19.9±5.0 μg/mL, 18.3±5.5 μg/mL in the previa and accreta groups versus 11.4±2.1 μg/mL in the control group (P<0.001). The ROC analysis was significantly lowest among the normal group with no significant difference between the previa and accrete groups. Maternal serum amyloid-A had significantly high diagnostic performance in differentiating previa and/or accreta groups from the normal group and low non-significant diagnostic performance in determining previa from accreta groups.Conclusion: Maternal SAA levels are increased in women with Placenta Accreta Spectrum.