Abstract :
Over the last 40 years, rate of cesarean delivery has risen from less than 10% to over 30% around the world, and almost simultaneously a 10-fold raise in the incidence of placenta accrete spectrum. Fine coordination among vascular endothelial growth factor, soluble fms-like tyrosine kinase 1 and placental growth factor is important for normal placental development and trophoblast invasion. To measure and compare the levels of circulating vascular endothelial growth factor, placental growth factor and soluble fms-like tyrosine kinase 1 in pregnant women with placenta accreta to a control group. A case control study which involved one hundred pregnant females were recruited from the Obstetric ward in Baghdad Teaching Hospital who were pregnant with 28 weeks of gestation or more, through the period from October 2018 to June 2019. Fifty patients were chosen with placenta accreta that ended with caesarean section hysterectomy and the other fifty patients were with normal placental location as a control. Means of VEGF, PlGF, and sFlt-1 were significantly lower among case group than that in controls. Cut point of VEGF level was 111.83 ng/L, of PlGF level was 23.29 ng/L, and of sFlt-1 was 5.32 ng/ml; so VEGF level < 111.83 ng/L, PlGF level < 23.29 ng/L, and sFlt-1 level < 5.32 ng/ml are predictors for risk of placenta accrete. No statistical significant correlations between markers’ level and all characteristics. Angiogenic and anti-angiogenic markers may have a role in the development of placenta accreta spectrum. VEGF, PIGF and sFlt-1 are decreased in patients with placenta accreta.
