Does Endometriosis Affect PAPP-A Concentration in First Trimester Fetal Screening Test?

Maria Caterina Corigliano, Federica Martelli, Maria Vittoria Capogna, Antonella Bruno, Roberto Sorge, Simona Sarta, Emilio Piccione, Adalgisa Pietropolli
In: Journal of Endometriosis and Pelvic Pain Disorders · 2016 · vol. 8(3) , pp. 94–100 · doi:10.5301/je.5000249 · W2522093332
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This study found that women with deep endometriosis have significantly higher serum PAPP-A concentrations, which may confound first-trimester aneuploidy screening.

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Abstract

Objective Pregnancy-associated plasma protein A (PAPP-A) is a macromolecular glycoprotein. The peritoneal fluid of women affected by endometriosis shows a significant increase of PAPP-A levels. Given the important role of PAPP-A in first trimester screening test, we wondered if its presence in the peritoneal fluid of women with endometriosis could affect biochemical parameters of the test performed during pregnancy. Methods A prospective study enrolled 78 women with singleton pregnancy who performed combined test between 11 + 0 and 13 + 6 weeks of gestation: 25 women with previous histological diagnosis of endometriosis and 53 women without. All patients were sampled to determine PAPP-A concentrations. Serum levels of PAPP-A were expressed in UI/L and in MoM (multiples of median). The two groups – endometriosis women and non-endometriosis women – were compared in order to find a possible different concentration of serum PAPP-A. Results We found an increased concentration of both PAPP-A UI/L and PAPP-A MoM in deep endometriosis patients versus ovarian endometriosis with significant difference in PAPP-A MoM (p = 0.018). We also found a significant association between the stage of the disease and PAPP-A UI/L and MoM levels (PAPP-A UI/L p = 0.05, PAPP-A MoM p = 0.01). Conclusions Women with deep endometriosis show increased serum PAPP-A concentrations compared to women with ovarian endometriosis. Likewise, women with moderate or severe stage of the disease show increased serum PAPP-A concentrations compared to women with minimum or mild disease. This increase could affect first trimester aneuploidy screening test and endometriosis could represent a confounding factor in the calculation of aneuploidy risk.

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endometriosis

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