The role of maternal serumbeta-HCG and PAPP-A levels at gestational weeks 10 to 14 in the prediction of pre-eclampsia.

Özkan Özdamar,Necmettin Koçak,İsmet Gün,Ercüment Müngen,Uğur Keskin

doi:10.12669/pjms.303.4554

Özkan Özdamar, Necmettin Koçak + Show 3 more

Open Access

https://doi.org/10.12669/pjms.303.4554

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Abstract

Objective: We aimed to detect whether maternal serum free β-hCG and PAPP-A levels and NT measurements vary between normal pregnancies and those that subsequently develop pre-eclampsia and to evaluate the role of these screening serum analytes in the prediction of pre-eclampsia. Methods: Using a case-control study design, we identified all women who had been screened by double test within 11+0 and 13+6 weeks of gestation and who had developed pre-eclampsia during the subsequent pregnancy course, over a 6-year period between January 2006 and December 2012 at two tertiary referral hospital. All women who had undergone a double test during that time, without a diagnosis of pre-eclampsia and who had not had any adverse obstetric outcomes, were also identified, and three women among them were randomly selected as controls for each case. Maternal and neonatal data were abstracted from the medical records and PAPP-A, β-hCG, NT and CRL MoM values were compared between the two groups. Results: Although β-hCG values show no statistically significant difference (p=0.882), PAPP-A levels were significantly reduced in the pre-eclampsia group compared to the control group (p<0.001). NT and CRL values showed no significant difference between the two groups (p=0.674 and p=0.558, respectively). Conclusion: Measuring PAPP-A in the first trimester may be useful in the prediction of pre-eclampsia.

Highlights

Pre-eclampsia is a heterogeneous, multisystem syndrome that accounts for 10% to 15% of maternal deaths. the signs and symptoms characteristically manifest in the second to third trimester, the underlying pathology may already be apparent from the very early stages of pregnancy
All those studies were conducted in the second trimester and they indicated this elevation to be between 15th to 19th weeks of gestation or after this period, close to the onset of the pre-eclampsia.Some other studies have been conducted during the first trimester and they concluded that there were no correlation between elevated maternal serum β-hCG levels and subsequent development of pre-eclampsia.[5,6]
Β-hCG values show no statistically significant difference (Mann Whitney U test, p=0.882), PAPP-A levels were significantly reduced in the pre-eclampsia group compared to the control group (p

Summary

Introduction

Pre-eclampsia is a heterogeneous, multisystem syndrome that accounts for 10% to 15% of maternal deaths. the signs and symptoms characteristically manifest in the second to third trimester, the underlying pathology may already be apparent from the very early stages of pregnancy. First and second trimester serum screening has been used for many years as a method of identifying fetuses at increased risk of chromosomal abnormalities, in particular trisomy 21 In addition to these aneuploidies, a variety of other pregnancy outcomes, such as pre-eclampsia, have been associated with abnormal values of these screening test analytes.By numerous studies, maternal serum β-hCG elevation, which has been defined with cut-offs varying from 2.0 MoM to 4.0 MoM, has been demonstrated to be in correlation with subsequent pre-eclampsia.[2-4]. All those studies were conducted in the second trimester and they indicated this elevation to be between 15th to 19th weeks of gestation or after this period, close to the onset of the pre-eclampsia.Some other studies have been conducted during the first trimester and they concluded that there were no correlation between elevated maternal serum β-hCG levels and subsequent development of pre-eclampsia.[5,6]

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Results

Conclusion