Circulating angiogenic factors in monochorionic twin pregnancies complicated by twin-to-twin transfusion syndrome and selective intrauterine growth restriction - 25/01/14
, Elad Ben Meir, BSc, Alexandra Berezowsky, BSc, Boaz Weisz, MD, Eyal Schiff, MD, Shali Mazaki-Tovi, MD, Shlomo Lipitz, MDAbstract |
Objective |
To determine maternal plasma levels of soluble vascular endothelial growth factor receptor-1 (sVEGFR-1), placental growth factor (PLGF), and soluble endoglin (sEng) in monochorionic diamniotic (MC/DA) twin pregnancies complicated by twin-to-twin transfusion syndrome (TTTS) or selective intrauterine growth restriction (sIUGR).
Study Design |
A longitudinal cohort study of pregnant women with MC/DA twins who were classified into 3 groups: (1) uncomplicated MC/DA twins (n = 22), (2) TTTS (n = 23), and (3) sIUGR (n = 15). Maternal plasma samples were obtained between 13-20 and 21-28 weeks of gestation and cord blood samples were collected at delivery. Maternal plasma concentrations of sVEGFR-1, PLGF, and sEng, as well as cord blood levels of sVEGFR-1 were measured by enzyme-linked immunoassay.
Results |
Maternal plasma levels of sVEGFR-1 and sEng were significantly higher in patients with TTTS at the early and late second trimester compared with normal monochorionic pregnancies (P < .01). In contrast, in the sIUGR group, sVEGFR-1 and sEng levels were significantly higher only at the late second trimester (P < .05). PLGF levels were significantly lower at the early and late second trimester in both TTTS and sIUGR compared with controls (P < .01). Plasma concentrations of sVEGFR-1 were significantly higher among TTTS pregnancies compared with sIUGR at the late second trimester (P = .027). Cord blood levels of sVEGFR-1 were significantly higher in the smaller intrauterine growth restricted twin compared with the normal cotwin.
Conclusion |
Monochorionic pregnancies complicated by TTTS and sIUGR are characterized by decreased angiogenic activity. The disparity in severity of the antiangiogenic state between TTTS and sIUGR suggests that these 2 conditions may represent a continuum.
Il testo completo di questo articolo è disponibile in PDF.Key words : angiogenic factors, monochorionic twins, PLGF, sEng, sIUGR, sVEGFR-1, TTTS
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| The authors report no conflict of interest. |
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| Cite this article as: Yinon Y, Ben Meir E, Berezowsky A, et al. Circulating angiogenic factors in monochorionic twin pregnancies complicated by twin to twin transfusion syndrome and selective intrauterine growth restriction. Am J Obstet Gynecol 2014;210:141.e1-7. |
Vol 210 - N° 2
P. 141.e1-141.e7 - febbraio 2014 Ritorno al numero
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