• Zeynep Gedik Ozkose, Suleyman Cemil Oglak, Mustafa Behram, Ozge Ozdemir, Zuat Acar, and Ismail Ozdemir.
• Department of Obstetrics & Gynaecology, Health Sciences University, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.
• J Coll Physicians Surg Pak. 2022 Dec 1; 32 (12): 157015751570-1575.

ObjectiveTo examine maternal serum Cripto-1 levels in placenta accreta spectrum (PAS) pregnancies and compare them with placenta previa (PP) cases and healthy pregnancies.Study DesignA prospective case-control study.Place And Duration Of StudyKanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey, from April to September 2021.MethodologySixty singleton pregnant patients with PP complicated with PAS were enrolled, 45 singleton pregnant women with a diagnosis of PP without PAS, and 48 healthy uncomplicated gestational age-matched singleton pregnant women. Cripto-1 levels were determined and evaluated.ResultsThe median maternal serum concentrations of Cripto-1 were greater in pregnant women with PAS (3.11 ng/mL) than in the PP (2.52 ng/mL) and the control groups (2.01 ng/mL, p<0.001). Based on the Youden index, a 2.557 ng/mL cut-off value of maternal serum Cripto-1 level had a 76.7% sensitivity and 72.1% specificity to diagnose pregnancies complicated with PAS. A negative and statistically significant linear relationship was found between maternal serum Cripto-1 concentration and the gestational week at birth (r= -0.325, p<0.001). A positive and statistically significant linear relationship was found between maternal serum concentrations of Cripto-1 and maternal length of hospital stay after birth (r= 0.320, p<0.001).ConclusionSerum Cripto-1 levels were significantly increased levels in pregnant women suffering from PAS than in pregnant women with PP and uncomplicated healthy pregnancies. Higher expression of Cripto-1 might be a crucial factor in the pathogenesis of PAS.Key WordsAbnormal placental implantation, placenta accreta spectrum, Cripto-1, Placenta previa.

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