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ROLE OF PRO BRAIN NATRIURETIC PEPTIDE LEVEL TO PREDICT MORBIDLY ADHERENT PLACENTA

Background: The incidence of placenta accreta is believed to be increasing globally. Serum pro brainnatriureticpeptide (Pro BNP) levels may be related with the abnormal invasion of placenta. Objective: To determine the benefi t of Pro-brain natriuretic peptide level asa biomarker to predict morbidly adherent placenta. Methods: A prospective case control study was conducted in the Department of Gynecology and Obstetrics at AlYarmouk Teaching Hospital in Baghdad for a period of one year from (April 2017 to April 2018). It involved 50 pregnant women diagnosed as placenta accreta (study group) and 50 pregnant women with placenta previa (control group) and matched for age, parity, gestational age and number of previous scars at the time of delivery. Allparticipants were submitted to blood sampling forthe determination of Pro-brain natriuretic peptide (ProBNP) concentration. Results: No statistical significant differences between study and control groups regarding age, Gestational Age, parity, Body Mass Index, and number of previous scars. The mean of Pro-brain natriuretic peptide (ProBNP) was significantly higher among patients in study group compared to control group(166.32 v ersus 77,21(pg/ml), P=0.001), The cut point of ProBNP was 133 pg/ml with AUC=76.8%, sensitivity= 56%, specificity= 94%, accuracy= 75%, PPV= 90.3%, and NPV= 68.1%, so this mean that all patients with ProBNP> 133 pg/ml can be diagnosed as placenta accreta. Conclusion: A significant association exists between Pro BNP levels and placentainvasion and may be a potential biomarker to aid in the antepartum prediction of placental accrete and may indicate degree of placental invasion.