Analysis Of Correlation Of Peripheral Blood Cell-free Placental MRNA、cell-free Fetal DNA、Vasculoendothelial Growth Factor And Soluble Fms-like Tyrosine Kinase Level With The Risk Of Placenta Accreta In Pregnant Women

Part 1 The Clinical Study of High Risk Factors of Placenta Accreta’s Relevance to the morbidity of Placenta AccretaObjective:Investigate the morbidity and the relevance of Placenta Accreta of a cohort of pregenant women who had the High Risk Factors of Placenta Accreta.Methods : This study examined the association between prior cesarean delivery、induced abortions(>2)、placenta previa and risk of placenta accreta with a cohort of pregnant women from January 2012 to December 2014 attending the gynecology clinic of Xin Hua hospital Affiliated to Shanghai Jiao Tong University School of Medicine.Results : We identified a cohort of 10788 primigravid women who participated in the gynecology clinic of Xin Hua hospital Affiliated to Shanghai Jiao Tong University School of Medicine during their pregnancy,58.16% of them,which the number is 6274,underwent a Cesarean delivery;There are 798 pregnancies with prior cesarean deliveries,23 of this cohort complicated with placenta accreta;There are 310 pregnancies with placenta previa,48 of this cohort complicated with placenta accreta.Placenta previa is associated with a 3.22% incidence of placenta increta compared to prior cesarean deliveries and induced abortions( >2) were all associated it with about 0.38%(P<0.05).Conclusion:In our experiment,we found a clear association between prior cesarean delivery、induced abortions(>2)、placenta previa and placenta accreta.Part 2 The Study of Vascular endothelial growth factor and soluble fms-like tyrosine kinase-1 in Peripheral Blood of Normal and women with High Risk Factors of Placenta Accreta(Include Placneta Arrecta women)in pregnancyObjective:To determinate the expression of VEGF and s Flt-1 in serum of placenta accreta、the cohort who with the high risk of placenta accreta and normal pregnant women. And investigate the differences of VEGF and s Flt-1 expression between those cohorts.Methods:The research objects were the ones in the Part2 of the study. Using ELISA techniques to determinate the expressions of VEGF and s Flt-1 in serum of pregnant women in each group. To analyse the differences of VEGF and s Flt-1 expression between the placenta accreta and normal ones by using one-way ANOVA.Results:The expression of VEGF in serum of the cohort of placenta accreta decreased insignificantly(P>0.05).The expression of s Flt-1 in serum had opposite results,and the cohorts of placenta previa and placenta accreta also had the high level of s Flt-1,but the expression was lower than the value of placenta increta(P<0.001).Conclusion:The cohort of placenta accreta had highest serum sFlt-1 level meanwhile.Part 3 The Study of Cell Free Fetal DNA in Peripheral Blood of Normal and women with High Risk Factors of Placenta Accreta(Include Placneta Arrecta women)in pregnancyObjective:To determinate the expression of TSPY-1 in plasma of placenta accreta、the cohort who with the high risk of placenta accreta and normal pregnant women. And investigate the differences of TSPY-1 expression between those cohorts.Methods:The research objects were the ones in the Part2 of the study. Using Real-Time techniques to determinate the expressions of TSPY-1 in plasma of pregnant women in each group. To analyse the differences of TSPY-1 expression between the placenta accreta and normal ones by using one-way ANOVA.Results:The expression of TSPY-1 in maternal plasma of the cohort of placenta increta were the highest(P<0.05);either placenta previa or placenta accreta had the high level of TSPY-1,but the differences between the groups were insignificant(P>0.05).Conclusion:The expression of TSPY-1 in maternal plasma of the pregnancy with placenta increta and those with high risk factors were increased.Part 4 The Study of Cell Free Placnetal m RNA in Peripheral Blood of Normal and women with High Risk Factors of Placenta Accreta(Include Placneta Arrecta women)in pregnancyObjective:To determinate the expression of h PL in plasma of placenta accreta、the cohort who with the high risk of placenta accreta and normal pregnant women. And investigate the differences of h PL expression between those cohorts.Methods:The research objects were the ones in the Part2 of the study. Using both Western Blotting and Real-Time techniques to determinate the expressions of h PL in plasma of pregnant women in each group. To analyse the differences of h PL expression between the placenta accreta and normal ones by using one-way ANOVA.Results:The expression of hPL-mRNA in plasma of the cohort of placenta increta was the highest among the groups;The differences between the groups were significant(P<0.05).Conclusion:The expression of h PL-m RNA in maternal plasma of the pregnancy with placenta accreta were increased.