Amniotic fluid and plasma concentrations of pregnancy‐associated plasma protein‐A (PAPP‐A) throughout pregnancy: comparison with other fetoplacental products

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Abstract
Summary. The development of a sensitive radioimmunoassay has enabled measurements of pregnancy‐associated plasma protein‐A (PAPP‐A) to be performed from early pregnancy. The present paper compares the plasma concentrations of PAPP‐A with the levels of two trophoblastic proteins, human placental lactogen (hPL) and the β‐subunit of human chorionic gonadotrophin (β‐hCG), with a steroid of fetoplacental origin, total oestriol (total E3), and with a fetal protein, α‐fetoprotein (AFP). PAPP‐A was also measured in amniotic fluid and in maternal urine. In contrast with the secretion of the other substances studied, which either reach a plateau or even decrease during the last 4 weeks of pregnancy, PAPP‐A steadily increased in the maternal circulation from 7 to 40 weeks gestation. It is proposed that PAPP‐A production is either not related to placental mass or that PAPP‐A is not of trophoblastic origin. The increase of PAPP‐A in amniotic fluids parallels the increase in maternal blood; virtually no PAPP‐A is excreted in urine.

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