Comparative study of Cripto-1 in placenta accreta and normal placenta

Abstract

Background: Placenta accreta (PA) is a life-threatening condition that endangers both the mother and infant. PA can result in postpartum haemorrhage, coagulation dysfunction, and puerperal infection. Cripto-1 is a glycosylphosphatidylinositol-anchored small molecular signalling protein and a member of epidermal growth factors EGF-CFC family. The purpose of this research was to study Cripto-1expression in placenta accreta and normal placenta, compare intensity of staining in both placenta accrete and normal placenta and throw light on possible role of cripto-1in invasion of the trophoblast through the myometrium. Methods: This study included 50 pregnant females with a singleton pregnancy. By ultrasound patients were classified into 2 equal groups: PA group diagnosed by (Loss of normal hypoechoic retroplacental zone, Retroplacental myometrial thickness of 1 mm, Blood vessels or placental tissue bridging uterine-placental margin, myometrial-bladder interface, or crossing uterine serosa, Multiple vascular lacunae within placenta, giving “Swisscheese” appearance) and normal Placenta (NP) group. All patients were subjected to doppler U/S, specimen collection, immunohistochemistry and Western blot. Results: There was a significant association between accreta and control groups as regard Cripto-1 levels (P= 0.001). There was a significant relationship between degree of invasion and cripto-1 levels in accreta group (P-value = 0.001). The incidence of complications was insignificantly different in comparison to Cripto-1 levels in accreta group. Conclusions: The increase in cripto-1 is related to the increase in the degree of invasion of the placenta, yet our study recorded that the severity of complications was insignificantly different among the different Cripto-1 levels in accreta groups. Therefore, we can correlate the risk of complications to the degree of invasion.