Serum Beta HCG and uterine artery Doppler studies in second trimester to predict preeclampsia and eclampsia

Abstract

Background: Hypertensive disorders during pregnancy remain amongst the most significant and intriguing unsolved problems in obstetrics. The study aims at testing the hypothesis that women with high serum beta hCG levels and alterations in waveforms in the uterine artery doppler in early second trimester have high risk of developing pre-eclampsia.Methods: Serum Beta hCG estimation was done by Sandwich chemiluminescence immunoassay method. All uterine artery waveforms were obtained using a Toshiba nemio ultrasound machine attached to a 3.5 MHz curvilinear transducer, with colour and pulsed Doppler abilities.Results: For prediction of preeclampsia or eclampsia uterine artery Doppler velocimetry alone shows specificity of 96.30%, sensitivity of 90%, positive predictive value of 94% and negative predictive value of 80%. When it is combined with serum beta HCG sensitivity and specificity are almost same, but alone serum beta HCG levels are showing sensitivity of 96% and specificity of just 76%.Conclusions: Abnormal waveforms on uterine Doppler studies are the better predictors for preeclampsia and eclampsia when done in early second trimester.

Role of serum beta human chorionic gonadotropin at 13-20 weeks of gestation as a predictor of hypertensive disorders of pregnancy

“…Like in present study, Mazhari F [3] , Soundararanjan P et al [4] Muthulakshmi D et al [5] , Kulkarni N et al [7] and Rajesh A et al [8] also use hCG production level as a measurement tool for the prediction of pregnancy induced hypertension.…”

“…In present study, we observed the sensitivity, specificity, positive predictive value and negative predictive value for β-hCG levels for >2MOM were 85.2%, 92.5%, 81.98% and 94.8% respectively. Chowdhary H et al [11] , Pawar P et al [9] , Revankar V M [13] , Soundararajan P et al [4] , Kulkarni N et al [7] , Mazhari F 3 had reported similar findings. In present study, the PIH patients cesarean was done in majority of the cases (77.8%) where as in normotensive patients cesarean was done in 52.0 % and the association was found to be statistically significant between hypertensive and normotensive patients (p< 0.05).…”

β-hCG levels in second trimester as a predictor of gestational hypertension and preeclampsia

“…According to this, it was evident that those pregnant women having very high serum beta HCG level >2 MOM and ≥40,000 mIU/ml, the incidence of PIH was more and sensitivity and specificity of β-hCG is 96% and 76% respectively. 6 Rajesh et al also found that β-hCG levels (Mean ± SD) were higher (69808.66±54764.7 vs. 38126.49±97419.2; p<0.28) in subjects who developed gestational hypertension with sensitivity of 75%, specificity of 72.5% and accuracy of 72.8%. 2 Many other authors also have shown significant association between high levels of beta HCG and hypertensive disorders in pregnancy.…”

“…[2][3][4] Gestational hypertension along with its sequelae that is preeclampsia and eclampsia can be best described as a human pregnancy-specific syndrome. 5,6 It affect virtually every organ system and widely varies in its clinical phenotypic expression. 6 damage and local hypoxia leading to hemorrhage, necrosis and end organ damage and therefore involves multiple organ systems.…”

“…5,6 It affect virtually every organ system and widely varies in its clinical phenotypic expression. 6 damage and local hypoxia leading to hemorrhage, necrosis and end organ damage and therefore involves multiple organ systems. It can decrease utero-placental blood flow of about 30-40%as compare to normal pregnancy.…”