Ekspresi Kadar Vcam-1 (Vascular Cell Adhesion Molecule 1) Pada Pasien PASD (Placenta Accreta Spectrum Disorder) Dibandingkan Pasien Dengan Kehamilan Normal

Dashari Ermandi Harahap; Hotma Partogi Pasaribu; Mohd. Rhiza Z. Tala

doi:10.62027/praba.v4i3.995

Authors

Dashari Ermandi Harahap Universitas Sumatera Utara
Hotma Partogi Pasaribu Universitas Sumatera Utara
Mohd. Rhiza Z. Tala Universitas Sumatera Utara

DOI:

https://doi.org/10.62027/praba.v4i3.995

Keywords:

Biomarker, Placenta accreta spectrum disorder, Pregnancy, Trophoblast invasion, VCAM-1

Abstract

Placenta accreta spectrum disorder (PASD) is an abnormal placental implantation associated with severe maternal morbidity and mortality, and its incidence continues to rise alongside the increase in cesarean deliveries. Vascular Cell Adhesion Molecule-1 (VCAM-1) is an inducible glycoprotein involved in trophoblast invasion, angiogenesis, and inflammation, all of which are implicated in the pathogenesis of PASD. This study aimed to compare pre-delivery serum VCAM-1 levels between pregnant women with PASD and those with normal pregnancy, and to explore its performance as a predictor of PASD. An analytic observational case-series was conducted at H. Adam Malik General Hospital and its affiliated network hospitals in Medan, Indonesia, from March to September 2024, involving 63 pregnant women (31 PASD, 32 normal pregnancy) recruited by consecutive sampling. Pre-delivery serum VCAM-1 was measured by ELISA and analyzed using independent t-test, one-way ANOVA, and receiver operating characteristic (ROC) curve analysis. Mean serum VCAM-1 was significantly higher in the PASD group (398.77 ± 77.36 ng/mL) than in the normal pregnancy group (293.13 ± 161.93 ng/mL; p=0.001). Levels rose progressively across histopathological severity — accreta 301.78, increta 440.63, percreta 518.21 ng/mL (p=0.007) — and across FIGO ultrasound staging (p=0.036). ROC analysis yielded an AUC of 0.763 (95% CI 0.641–0.885) with a cut-off of 307 ng/mL, sensitivity 71%, and specificity 65.6%. Serum VCAM-1 was significantly associated with PASD and its severity, suggesting potential utility as an adjunctive biomarker for pre-delivery PASD risk stratification.

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