Luckas M, Hawe J, Meekins J, Neilson J, Walkinshaw S
Department of Obstetrics & Gynaecology, Liverpool University, Liverpool Women's Hospital, UK.
Acta Obstet Gynecol Scand. 1998 Apr;77(4):381-4.
To prospectively assess maternal serum free beta human chorionic gonadotrophin (beta hCG) estimation between 15 and 18 weeks gestation, as a screening test for pre-eclampsia in primigravid women.
A prospective longitudinal study in a University Teaching Hospital. The study population was 430 primigravid women, who had maternal serum free beta hCG levels measured as part of antenatal serum screening for Down's Syndrome in the second trimester, who booked consecutively within the unit and went on to deliver on the unit's labor ward. These women were followed during their subsequent pregnancy and categorized into those who remained normotensive and those who developed pre-eclampsia on both clinical and biochemical grounds. The beta hCG levels were used to construct a receiver operator characteristics curve (ROC) to assess the screening potential for pre-eclampsia.
Nineteen (4.4%) women in the study group developed pre-eclampsia. The median second trimester free beta hCG multiples of the median (MOM) was significantly elevated compared to that of the control group (1.52 vs 1.10, p=0.03). The ROC curve shows that for a sensitivity of 79%, the specificity was only 54%.
Maternal serum free beta hCG alone measured in the second trimester is not clinically useful as a screening test for pre-eclampsia in primigravid women. It has, however, some predictive value.
前瞻性评估孕15至18周时孕妇血清游离β人绒毛膜促性腺激素（β-hCG）水平，作为初产妇子痫前期的筛查试验。
在一所大学教学医院进行前瞻性纵向研究。研究对象为430名初产妇，她们在孕中期进行了唐氏综合征产前血清筛查，其中包括测定孕妇血清游离β-hCG水平，这些产妇在该单位连续登记并在该单位的产房分娩。在她们随后的孕期对这些妇女进行随访，并根据临床和生化标准将其分为血压正常组和发生子痫前期组。利用β-hCG水平构建受试者工作特征曲线（ROC），以评估子痫前期的筛查潜力。
研究组中有19名（4.4%）妇女发生子痫前期。与对照组相比，孕中期游离β-hCG中位数倍数（MOM）显著升高（1.52对1.10，p=0.03）。ROC曲线显示，当灵敏度为79%时，特异度仅为54%。
仅在孕中期测定孕妇血清游离β-hCG作为初产妇子痫前期的筛查试验在临床上并无用处。然而，它具有一定的预测价值。
