Transthyretin is a promising prognostic marker of non-developing pregnancy in hypothyroidism

Abstract

Non-developing pregnancy is one of the most important problems in the practice of an obstetrician-gynecologist. Transthyretin is a transplacental transport protein of T3, T4 and is expressed in cyto- and syncytiotrophoblast cells. Transthyretin may be a promising prognostic marker for non-developing pregnancy.Aim. The purpose of this study is to evaluate the prognostic capabilities of the serological marker – transthyretin in patients with missed abortion.Materials and Methods. A prospective cohort study was performed, which included 155 women aged 18-45 years, 155 of them with an undeveloped pregnancy and 47 with a progressive gestation period of 6-12 weeks. All participants were divided into 3 classification groups according to the gestation period. For the examination of the patients, clinical and statistical (questioning of the examined women, analysis of medical records), laboratory (clinical blood analysis, biochemical blood analysis, including thyroid-stimulating and thyroid-stimulating hormones), instrumental research methods (ultrasound examination of the pelvic organs) were used. The concentration of transthyretin in the patients of the studied groups was determined by proteomic analysis of blood serum using liquid chromatography and tandem mass spectrometry (LC-MS)..Results. Hypothyroidism was diagnosed in 19.3 % of all cases of missed abortion. According to the results of proteomic analysis, the lowest concentration of transthyretin was revealed in missed abortion at 11−12 weeks (p < 0.001).Conclusion. А significantly reduced level of transthyretin in early pregnancy is a possible predictor of the threat of miscarriage.

Keywords

• missed abortion
• transthyretin
• hypothyroidism