DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20173263

Serum β-hcg levels between 12 to 20 weeks of gestation in prediction of hypertensive disordrers of pregnancy

Muthulakshmi D., Sasirekha R., Medha R.

Abstract


Background: This study was undertaken to study the association of serum β hCG levels between 12 to 20 weeks of gestation and development of hypertensive disorders of pregnancy and to assess the association between the levels of β hCG and severity of hypertensive disorders of pregnancy. Study design: Prospective cohort study (200 uncomplicated primigravida).

Methods: All women between 12 to 20 weeks of pregnancy meeting the selection criteria, attended antenatal OPD in JIPMER were recruited for this study after informed consent. The venous blood samples were obtained from the subjects for β-hCG analysis. Serum β hCG level was measured by Enzyme Linked Immunoassay System (ELISA) and expressed as mIU/ml. Multiples of median were calculated from the median of the sample population and were considered as raised if it was >2 MOM. The cases were followed up until delivery and observed for development of hypertensive disorders of pregnancy.

Results: Out of 200 cases, 185 cases were followed completely till term. Among 185 cases who were followed up, 10 women developed hypertensive disorders of pregnancy, accounting for 5.4% in the study group. Out of the total 185 women who were studied, 132 had β hCG levels ≤2 MOM and 53 had β hCG levels >2 MOM. Among 132 women (94.7%) with β hCG levels ≤2 MOM, 7 (5.3%) developed hypertensive disorders. Among 53 cases (94.3%) with β hCG levels >2 MOM, 3 women (5.7%) developed hypertensive disorders. The incidence of HDP was almost similar in both the groups, 5.3% among those whose β hCG levels were ≤2MOM and 5.7% among those who had β hCG levels >2 MOM (p value - 0.923).

Conclusions: From the present study, it may be concluded that high serum β hCG levels (2 MOM) estimated between 12 to 20 weeks of pregnancy were not predictive of development of hypertensive disorders later in pregnancy.

 


Keywords


β hCG, Hypertensive disorders, Preeclampsia

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References


Report of the National High Blood Pressure Education Program. Working group report on high blood pressure in pregnancy. Am J Obstet Gynecol. 2000;183(1):S1-S22.

Conde-Agudelo A, Villar J, Lindheimer M. World Health Organization Systematic Review of Screening Tests for Preeclampsia. J Obstet Gynaecol Ind. 2004;104(6):1367-91.

Roiz-Hernandez J, de Cabello-Martinez J, Fernandez Mejia M. Human chorionic gonadotropin levels between 16 and 21 weeks of pregnancy and prediction of preeclampsia. Int J Gynecol Obstet. 2006; 92:101-5.

Kaur G, Jain V, Mehta S, Himani S. Prediction of PIH by maternal serum Β hCG levels in the second trimester of pregnancy. J Obstet Gynecol India. 2012;62(1):32-4.

Stamilo DM, Sehdev HM, Morgan MA, Propert K, Macones GA. Can antenatal clinical and biochemical markers predict the development of severe preeclampsia? Am J Obstet Gynecol. 2000;182(3):589-94.

Mikic TS, Johnson P. Second trimester maternal serum β human chorionic gonadotrophin and pregnancy outcome. Br J Obstet Gynecol. 1999;106(6):598- 600.

Raty R, Koskinen P, Alanen A, Irjala K, Matinlauri I, Ekblad U. Prediction of Pre-eclampsia with Maternal Mid-trimester Total Renin, Inhibin A, AFP and Free-hCG Levels. Prenat Diagn. 1999;19(2):122-7.

Morssink LP, Heringa MP, Beekhuis JR, De Wolf BT, Mantingh A. The association between hypertensive disorders of pregnancy and abnormal second-trimester maternal serum levels of hCG and alpha-fetoprotein. Obstet Gynecol. 1997;89(5.1):666-70.

Lee L, Sheu B, Shau W, Liu D, Lee y, Huang S. Mid-trimester b-hCG levels incorporated in a multifactorial model for the prediction of severe pre-eclampsia. J Prenat Diagn. 2000;20(9):738-43.