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Obstetrics & Gynecology 1992;80:83-86
© 1992 by The American College of Obstetricians and Gynecologists
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The Association Between Unexplained Second- Trimester Maternal Serum hCG Elevation and Pregnancy Complications

R. GONEN, MD, R. PEREZ, BSc, M. DAVID, DSc, H. DAR, DSc, R. MERKSAMER, BSc and M. SHARF, MD

From the Department of Obstetrics and Gynecology and the Simon Winter Institute of Human Genetics, Bnai Zion Medical Center, Faculty of Medicine, Technion, Haifa, Israel

Abstract

Objective: We conducted this cohort analytic study to determine whether women with unexplained elevations of maternal serum hCG at 16-20 weeks' gestation are at increased risk for pregnancy complications and adverse perinatal outcomes.

Methods: The inclusion criteria were a singleton gestation, a confirmed gestational age, and an hCG level greater than 2.5 multiples of the median (MOM). The exclusion criteria were fetal anomalies, an abnormal karyotype, and a maternal serum alpha-fetoprotein (MSAFP) level greater than 2.5 MOM. A group of randomly selected women with normal hCG and MSAFP levels served as controls.

Results: Of the 6011 women screened, 284 (4.7%) had an unexplained elevated hCG level. Patients with elevated levels of hCG had a significantly higher risk for hypertension (odds ratio 4.4; 95% confidence interval [CI] 1.9-10) and fetal growth restriction (odds ratio 2.8; 95% CI 1-7). Women with hCG levels greater than 4 MOM also had an increased risk of preterm delivery.

Conclusion: Pregnancies with unexplained elevated hCG levels should be regarded as high-risk pregnancies and managed accordingly.




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