Analytical Assessment of PLGF-1, CA-125, and Fibrinogen as Biomarkers in Pregnancy-Related Hysterectomy

Background: Hysterectomy is commonly performed during gestation or postpartum due to its life-threatening complications, including postpartum hemorrhage and placenta accreta. Reproducible biomarkers could assist early identification and management of at-risk patients. Objective: The purpose of this study was to examine serum placental growth factor-1 (PLGF-1), carbohydrate antigen 125 (CA-125), and fibrinogen levels for women with hysterectomy between those due to hemorrhage or placenta accreta relative to the control group. Methods: Ninety serum samples were obtained from women aged 19-42 years old. The patients were split into two subgroups based on the indication for hysterectomy (hemorrhage or placenta accreta) (n = 70). A control group consisted of women who had uneventful vaginal deliveries (n = 20). ELISA and manual assays were used to study biomarkers. Results: Levels of PLGF-1 and CA-125 were found significantly reduced in the hysterectomy groups, but fibrinogen baseline levels increased dramatically (P < 0.0001). Both advanced maternal age and an increasing number of cesarean sections were related to greater changes in perinatal biomarkers. Conclusions: Expression levels of PLGF-1, CA125, and fibrinogen may be potential biomarkers for evaluating the risk of hysterectomy in pregnancy-related complications. Validation in larger cohorts is warranted.