Evaluation of maternal serum protein biomarkers in the prenatal evaluation of placenta accreta spectrum: A systematic scoping review

Abstract Introduction Placenta accreta spectrum (PAS) is an increasingly commonly reported condition due to the continuous increase in the rate of cesarean deliveries (CD) worldwide; however, the prenatal screening for pregnant patients at risk of PAS at birth remains limited, in particular when ima...

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Main Authors: Matthew Givens, Ivaila Valcheva, Brett D. Einerson, Ewelina Rogozińska, Eric Jauniaux
Format: Article
Language:English
Published: Wiley 2024-12-01
Series:Acta Obstetricia et Gynecologica Scandinavica
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Online Access:https://doi.org/10.1111/aogs.14918
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author Matthew Givens
Ivaila Valcheva
Brett D. Einerson
Ewelina Rogozińska
Eric Jauniaux
author_facet Matthew Givens
Ivaila Valcheva
Brett D. Einerson
Ewelina Rogozińska
Eric Jauniaux
author_sort Matthew Givens
collection DOAJ
description Abstract Introduction Placenta accreta spectrum (PAS) is an increasingly commonly reported condition due to the continuous increase in the rate of cesarean deliveries (CD) worldwide; however, the prenatal screening for pregnant patients at risk of PAS at birth remains limited, in particular when imaging expertise is not available. Material and Methods Two major electronic databases (MEDLINE and Embase) were searched electronically for articles published in English between October 1992 and January 2023 using combinations of the relevant medical subject heading terms and keywords. Two independent reviewers selected observational studies that provided data on one or more measurement of maternal blood‐specific biomarker(s) during pregnancies with PAS at birth. PRISMA Extension for Scoping Review (PRISMA‐ScR) was used to extract data and report results. Results Of the 441 reviewed articles, 29 met the inclusion criteria reporting on 34 different biomarkers. 14 studies were retrospective and 15 prospective overall including 18 251 participants. Six studies had a cohort design and the remaining a case–control design. Wide clinical heterogeneity was found in the included studies. In eight studies, the samples were obtained in the first trimester; in five, the samples were collected on hospital admission for delivery; and in the rest, the samples were collected during the second and/or third trimester. Conclusions Measurements of serum biomarkers, some of which have been or are still used in screening for other pregnancy complications, could contribute to the prenatal evaluation of patients at risk of PAS at delivery; however, important evidence gaps were identified for suitable cutoffs for most biomarkers, variability of gestational age at sampling and the potential overlap of the marker values with other placental‐related complications of pregnancy.
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spelling doaj-art-6e83f3b352214ebeb8c3aa0f23d28d062025-08-20T02:09:24ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122024-12-01103122335234710.1111/aogs.14918Evaluation of maternal serum protein biomarkers in the prenatal evaluation of placenta accreta spectrum: A systematic scoping reviewMatthew Givens0Ivaila Valcheva1Brett D. Einerson2Ewelina Rogozińska3Eric Jauniaux4Department of Obstetrics and Gynecology (Drs Givens and Einerson) University of Utah Health (UUH) Salt Lake City Utah USAEGA Institute for Women's Health, Faculty of Population Health Sciences University College London London UKDepartment of Obstetrics and Gynecology (Drs Givens and Einerson) University of Utah Health (UUH) Salt Lake City Utah USAThe EVIdencE Synthesis and Methodology Group for Women's Health Research (EVIE) Institute of Clinical Trials & Methodology, University College London London UKEGA Institute for Women's Health, Faculty of Population Health Sciences University College London London UKAbstract Introduction Placenta accreta spectrum (PAS) is an increasingly commonly reported condition due to the continuous increase in the rate of cesarean deliveries (CD) worldwide; however, the prenatal screening for pregnant patients at risk of PAS at birth remains limited, in particular when imaging expertise is not available. Material and Methods Two major electronic databases (MEDLINE and Embase) were searched electronically for articles published in English between October 1992 and January 2023 using combinations of the relevant medical subject heading terms and keywords. Two independent reviewers selected observational studies that provided data on one or more measurement of maternal blood‐specific biomarker(s) during pregnancies with PAS at birth. PRISMA Extension for Scoping Review (PRISMA‐ScR) was used to extract data and report results. Results Of the 441 reviewed articles, 29 met the inclusion criteria reporting on 34 different biomarkers. 14 studies were retrospective and 15 prospective overall including 18 251 participants. Six studies had a cohort design and the remaining a case–control design. Wide clinical heterogeneity was found in the included studies. In eight studies, the samples were obtained in the first trimester; in five, the samples were collected on hospital admission for delivery; and in the rest, the samples were collected during the second and/or third trimester. Conclusions Measurements of serum biomarkers, some of which have been or are still used in screening for other pregnancy complications, could contribute to the prenatal evaluation of patients at risk of PAS at delivery; however, important evidence gaps were identified for suitable cutoffs for most biomarkers, variability of gestational age at sampling and the potential overlap of the marker values with other placental‐related complications of pregnancy.https://doi.org/10.1111/aogs.14918maternal serumplacenta accretaplacenta accreta spectrumplacenta previa accretaprotein biomarkersscreening
spellingShingle Matthew Givens
Ivaila Valcheva
Brett D. Einerson
Ewelina Rogozińska
Eric Jauniaux
Evaluation of maternal serum protein biomarkers in the prenatal evaluation of placenta accreta spectrum: A systematic scoping review
Acta Obstetricia et Gynecologica Scandinavica
maternal serum
placenta accreta
placenta accreta spectrum
placenta previa accreta
protein biomarkers
screening
title Evaluation of maternal serum protein biomarkers in the prenatal evaluation of placenta accreta spectrum: A systematic scoping review
title_full Evaluation of maternal serum protein biomarkers in the prenatal evaluation of placenta accreta spectrum: A systematic scoping review
title_fullStr Evaluation of maternal serum protein biomarkers in the prenatal evaluation of placenta accreta spectrum: A systematic scoping review
title_full_unstemmed Evaluation of maternal serum protein biomarkers in the prenatal evaluation of placenta accreta spectrum: A systematic scoping review
title_short Evaluation of maternal serum protein biomarkers in the prenatal evaluation of placenta accreta spectrum: A systematic scoping review
title_sort evaluation of maternal serum protein biomarkers in the prenatal evaluation of placenta accreta spectrum a systematic scoping review
topic maternal serum
placenta accreta
placenta accreta spectrum
placenta previa accreta
protein biomarkers
screening
url https://doi.org/10.1111/aogs.14918
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