Kaur Gurmandeep, Jain Vimla, Mehta Seema, Himani Sunita
Obstetrics & Gynaecology, Mahila Chikitsalaya S.M.S. Medical College, Jaipur, 302 004 India.
J Obstet Gynaecol India. 2012 Feb;62(1):32-4. doi: 10.1007/s13224-012-0151-y. Epub 2012 Apr 20.
To test the hypothesis that women with high serum beta-HCG levels in early pregnancy are at higher risk of developing PIH.
Serum beta-HCG estimation was done by CLIA method in 200 women between 13 and 20 weeks of gestation, selected randomly for this study from July 2008 to Aug 2009. Multiple of median (MOM) was calculated from charts of norms available for that week of pregnancy. They were followed till delivery for development of PIH and pregnancy outcome and results analysed statistically with Chi-square test and Z test.
Out of 200 cases, 178 (89 %) were finally evaluated. Of whom 22 (12.36 %) cases developed PIH. Beta HCG levels were considered raised if the levels were >2MOM.20 (83.33 %) out of 24 cases with beta HCG levels >2MOM developed PIH against 2 (1.2 %) cases out of 154 having beta HCG levels ≤2 MOM (P value <0.001). Also, higher levels of beta HCG are associated with increased severity of PIH (P value <0.01). The sensitivity was 90.91 %, specificity was 97.44 % and positive predictive value was 83.33 %.
The study concluded that the serum beta HCG estimation at mid trimester (13-20 weeks) is a good predictor of PIH and higher levels of beta HCG are associated with increased severity of PIH.
检验妊娠早期血清β-人绒毛膜促性腺激素（β-HCG）水平高的女性发生妊娠期高血压疾病（PIH）风险更高这一假设。
采用化学发光免疫分析（CLIA）法对200名妊娠13至20周的女性进行血清β-HCG测定，这些女性于2008年7月至2009年8月随机选取用于本研究。根据该孕周的标准图表计算中位数倍数（MOM）。对她们进行随访直至分娩，观察PIH的发生及妊娠结局，并采用卡方检验和Z检验对结果进行统计学分析。
200例患者中，最终178例（89%）得到评估。其中22例（12.36%）发生PIH。若β-HCG水平>2MOM，则认为其升高。24例β-HCG水平>2MOM的患者中有20例（83.33%）发生PIH，而154例β-HCG水平≤2MOM的患者中有2例（1.2%）发生PIH（P值<0.001）。此外，β-HCG水平越高，PIH的严重程度越高（P值<0.01）。敏感性为90.91%，特异性为97.44%，阳性预测值为83.33%。
该研究得出结论，孕中期（13 - 20周）血清β-HCG测定是PIH的良好预测指标，且β-HCG水平越高，PIH的严重程度越高。
