pregnancy-associated plasma protein-A (PAPP-A)
المؤلف:
Kathleen Deska Pagana, Timothy J. Pagana, Theresa Noel Pagana.
المصدر:
Mosbys diagnostic and laboratory test reference
الجزء والصفحة:
15th edition , p727
2025-08-11
404
Type of test Blood
Normal findings
Normal values vary by laboratory and duration of pregnancy
Test explanation and related physiology
Pregnancy-associated plasma protein-A (PAPP-A) is made by the trophoblasts and released into the maternal circulation during pregnancy. Women with low blood levels of PAPP-A at 8 to 14 weeks of gestation have an increased risk of intrauterine growth restriction, trisomy 21, premature delivery, preeclampsia, and stillbirth. This protein rapidly rises in the first trimester of normal pregnancy. However, in Down syndrome–affected pregnancy, serum levels are half that of unaffected pregnancies. Furthermore, low levels of PAPP-A in maternal serum in the first trimester are associated with adverse fetal outcomes, including fetal death in utero and intrauterine growth retardation. This test is commonly used with other pregnancy and screening tests.
PAPP-A is present in unstable atherosclerotic plaques, and circulating levels are elevated in acute coronary syndromes, which may reflect the instability of the plaques. PAPP-A is an independent marker of unstable angina and acute myocardial infarction.
Interfering factors
• Levels increase with increased maternal body weight and longer duration of pregnancy.
Procedure and patient care
• See inside front cover for Routine Blood Testing.
• Fasting: no
• Blood tube commonly used: red
• Allow the patient to express her concerns and fears regarding the potential for birth defects.
* Assist the patient in scheduling and obtaining more accurate diagnostic testing if the results are positive.
Abnormal findings
- Positive screening tests (trisomy 21, trisomy 18, neural tube defects, abdominal wall defects)
- Coronary atherosclerotic disease
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