Oancea Mihaela Daniela, Costin Nicolae, Pop Daria Maria, Ciortea Razvan, Mihu Dan
Department of Obstetrics and Gynecology II, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Clujul Med. 2013;86(4):347-51. Epub 2013 Nov 6.
Preeclampsia remains a major problem of modern obstetrics with insufficiently elucidated etiology; early detection would diminish maternal and fetal mortality and morbidity. The aim of this study was to determine the serum values of β-hCG in the first and second trimesters of pregnancy and PAPP-A values in the first trimester of pregnancy in pregnant women with risk factors for preeclampsia, in order to evaluate their relevance in the prediction of this disorder.
We performed a prospective longitudinal study on 120 pregnant women divided into two groups according to the evolution of pregnancy: group I - 26 pregnant women who developed preeclampsia and group II - 94 pregnant women who did not develop preeclampsia and had a physiological evolution of pregnancy.
Our results indicate the association between high β-hCG levels in the first and second trimesters of pregnancy and the development of PE, β-hCG having the highest predictive power in the second trimester. We also obtained a positive association between low serum levels in PAPP-A in the first trimester and onset of PE. The predictive power of conjugated β-hCG and PAPP-A values in the first trimester of pregnancy was better that any other marker analyzed separately.
Increased β-hCG levels in the first and second trimesters of pregnancy and low PAPP-A levels in the second trimester of pregnancy are associated with a higher risk for PE, the study providing only a modest efficiency of the prediction capacity.
子痫前期仍是现代妇产科学中的一个主要问题，其病因尚未完全阐明；早期发现可降低母婴死亡率和发病率。本研究的目的是测定有子痫前期危险因素的孕妇妊娠早、中期的血清β-hCG值以及妊娠早期的妊娠相关血浆蛋白-A（PAPP-A）值，以评估它们在预测该疾病中的相关性。
我们对120名孕妇进行了一项前瞻性纵向研究，根据妊娠进展将其分为两组：第一组 - 26名发生子痫前期的孕妇，第二组 - 94名未发生子痫前期且妊娠过程正常的孕妇。
我们的结果表明，妊娠早、中期β-hCG水平升高与子痫前期的发生有关，β-hCG在妊娠中期具有最高的预测能力。我们还发现妊娠早期PAPP-A血清水平低与子痫前期的发生呈正相关。妊娠早期结合β-hCG和PAPP-A值的预测能力优于单独分析的任何其他标志物。
妊娠早、中期β-hCG水平升高以及妊娠中期PAPP-A水平降低与子痫前期风险较高有关，该研究仅提供了适度的预测能力。
