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Korean Journal of Obstetrics & Gynecology 2001;44(8):1407-1411.
Published online August 1, 2001.
The association between unexplained elevation of second trimester maternal serum beta-hCG and pregnancy outcomes.
Kyung Chul Song, Ji Sung Lee, Seung Ug Lim, Gi Nam Eom, Cheol Gyu Kang, Yu Duk Choi, Sug Young Kim, Byoung Chul Hwang, Gwang Jun Kim, Eui Don Lee, Chan Yong Park, Jong Min Lee, Ji Young Kim, Sang Hwan Han, Jong Ho Kim
Department of Obstetrics and Gynecology, Preventive medicine and Nuclear medicine Gachon Medical School, Inchon, Korea.
Abstract
OBJECTIVE
The purpose of this study was to determine whether unexplained elevation of second-trimester maternal serum beta-human chorionic gonadotropin (beta-hCG) is associated with adverse pregnancy outcomes. METHOD: Between January 1998 and December 1999, we evaluated 2112 pregnant women undergoing second trimester triple marker screening test who delivered at our hospital. Inclusion criteria were singleton pregnancy, confirmed gestational age, and hCG level greater than 2.0 MoM. The exclusion criteria were fetal anomaly, abnormal karyotype, MSAFP level greater than 2.0 MoM, uE3 level less than 0.4 MoM, and referred patients with pregnancy-induced hypertension (PIH). A group of randomly selected women with normal maternal serum hCG and AFP levels served as control. RESULTS: Women with unexplained elevation of hCG level showed increased risks for PIH (p<0.001) and preterm delivery (p<0.003). There were no significant diffrences between study and control groups with respect to placental abruption, fetal distress, PROM, intrauterine fetal death, and apgar score. CONCLUSION: Pregnancies with unexplained elevation of hCG levels should be regarded as high-risk pregnancies and managed accordingly. The combination with these biomarkers such as VEGF, plasminogen activating factor I and AT-III as a screening test for PIH may be useful.
Key Words: pregnancy-induced hypertension, beta-human chorionic gonadotropin


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