TO PREDICT PIH BY STUDYING MIDTRIMESTER SERUM BETA HCG AND ALFA FETOPROTEIN AND ITS ROLE IN FETO-MATERNAL OUTCOME

Dr. Gurcharan Kaur, Dr. Himanshi Sharma

Abstract


Background: PIH is the most common cause of feto-maternal morbidity and mortality worldwide. The objective of this study was to determine the predictive value of mid-trimester serum beta-HCG and Alfa fetoprotein in PIH andits Fetomaternal outcome.

Method: A total 200 women, fulfilling the inclusion and exclusion criteria between 12- 24 week of gestation were enrolled, whose serum beta HCG and alfa fetoprotein values were determined byradioimmunoessay at enrollment and their multiple of medians were calculated, values>2MoM were considered raised. They werefollowed till delivery for the PIH development andwere categorized into PIH and normotensive group andfetomaternal outcomes were measured in respective groups.

Results:Out of 200 patients taken, 14 had spontaneous abortion, only 178 were followed for outcome measurement. Of 178 patients, 31(17.5%) developed PIH and 147(82.5%)remained normotensive. In PIH group mean value  of serum beta HCG and S.AFP was 68472.29 ± 15018.87 and 119.36 ± 36.88 respectively whereas in normotensives it was27728.61 ± 5689.66 and 40.26 ± 11.09 respectively.29(93.5%) out of 31 PIH patients had beta HCG >2MoM whereas Only 3(2%) out of 147 normotensive patients had beta HCG value >2MoM making sensitivity and specificity of >2MoM beta HCG in PIH prediction is 93.5% and 97.96% respectively. Similarly,26(83.9%) out of 31 PIH patients have S.AFP >2MoM whereas Only 3(2%) of normotensive patients have S.AFP value >2MoM making sensitivity and specificity of >2MoM S.AFP in PIH predictionis 83.8% and 97.9% respectively. Maternal complication abruption (9.6%), preterm labor (22.5%), post-partumhemorrhage (22.58%),oligohydramnios (22.5%), derangedDoppler (9.68%) were higher in PIH group.Still birth (3.23%) and IUD (6.45%), IUGR (25%), were higher in PIH group.

Conclusion:Our study concludes that if second trimester serum beta HCG and serum AFP values were  >2MoM, it was associated with development of PIH and poor fetomaternal outcome.


Keywords


maternal serum beta HCG, maternal serum AFP, PIH.

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References


Kabukcu A, LutfuOnderoglu S, Laheli Y. Women with elevated second trimester human chorionic gonadotropin level are at increased risk for preeclampsia. Turk J Med Sci. 1998; 28:273–276.

Yaron Y, Cherry M, Kramer RL et al. Second-trimester maternal serum marker screening: maternal serum alphafetoprotein, beta-human chorionic gonadotropin, estriol, and their various combinations as predictors of pregnancy outcome. Am J ObstetGynecol1999; 181:968-74.

Luckas M, Hawe J, Meekins J, Neilson J, Walkinshaw S. Second trimester serum free beta human chorionic gonadotrophin levels as a predictor of pre-eclampsia. ActaObstetGynecolScand 1998;77(4):381-4.

Benn PA, Horne D, Briganti S, Rodis JF, Clive JM. Elevated second-trimester maternal serum hCG alone or in combination with elevated alpha-fetoprotein. ObstetGynecol 1996;87(2):217-22.

Ashour AM, Lieberman ES, Haug LE, Repke JT. The value of elevated second-trimester beta-human chorionic gonadotropin in predicting development of preeclampsia. Am J ObstetGynecol 1997;176(2):438-42

Wenstrom KD, Owen J, Davis RO, Brumfield CG. Prognostic significance of unexplained elevated amniotic fluid alpha-fetoprotein. ObstetGynecol 1996;87(2):213-6.

Räty 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 betahCG levels. PrenatDiagn 1999;19(2):122-7.


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