β-hCG Values Research Articles

Problems in the Diagnosis of Ectopic Pregnancy

Problems in the diagnosis of ectopic pregnancy have been assessed over a 4-month period at King Edward Memorial Hospital. Twenty-three of thirty women (77%) were sent home after their initial presentation with symptoms of their ectopic pregnancy. Thirteen were sent home from major teaching hospitals and the remaining 10 by their general practitioners. In 76 patients, laparoscopy was performed to exclude ectopic pregnancy; the diagnosis was confirmed in only 30. Plasma beta HCG values were elevated in all patients with an ectopic pregnancy within the Fallopian tube. The finding of a beta HCG value of less than 2.5 i.u./l could have allowed 36 of these patients to avoid diagnostic laparoscopy. Nine patients with intrauterine pregnancies (5 continuing and 4 aborting) might have avoided laparoscopy if ultrasonography had been used. Careful application of these tests, together with good history taking, will minimise the number of patients in whom an incorrect diagnosis is made.

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

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.