A research report submitted to the Faculty of Health Sciences, University of the
Witwatersrand in partial fulfilment of the requirements for the degree of
Master of Medicine in the branch of Obstetrics & Gynaecology. Johannesburg, 2017. / Background and objectives
Evidence supporting an association between HPV infection and pre-eclampsia has
recently been published. Pre-eclampsia is a common, serious complication of
pregnancy of complex aetiology that to date has not been fully described. Human
papillomavirus (HPV) is a ubiquitous, DNA-virus with tropism for human mucosal
commonly found in the female genital tract. Association between placental HPV
infection and preterm labour and pregnancy loss has previously been described. This
study tested the hypothesis that an association exists between HPV in the placenta
or the cervix and clinical pre-eclampsia, or levels of its associated biomarkers,
soluble fms-like tyrosine kinase (sFLT1) and placental growth factor (PlGF).
Methods
Women with pre-eclampsia were matched to healthy controls. All subjects were
delivered by caesarean section, and cervical and placental samples were collected at
the time of delivery. These samples were tested for HPV using a polymerase chain
reaction (PCR) assay. Serum levels of soluble fms-like tyrosine kinase (sFLT1) and
placental growth factor (PlGF) at the time of delivery were tested. Placental and
cervical HPV was compared to the outcomes of clinical pre-eclampsia and serum
sFLT1 and PlGF levels.
Results and conclusion
While clinically apparent disease was associated with increased levels of sFLT1 and
decreased levels of PlGF, HPV was not detected in any of the placental specimens
using the PCR assay. As a result, no association was found between placental HPV
detection and clinically apparent pre-eclampsia or deranged serum levels of sFLT1 or
PlGF. HPV was very common in cervical samples and showed a non-significant trend
towards negative association with clinical pre-eclampsia and sFLT1, and a positive
association with PlGF. This may be an effect of cervical HPV infection on the
vascular endothelial growth factor (VEGF) signalling system that may explain its
association with miscarriage. / LG2018
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/25614 |
| Date | January 2017 |
| Creators | Retief, Pieter Francois |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf |
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