Can HCG MoM Ratio Predict Preeclampsia?

Yıl 2024, Cilt: 6 Sayı: 1, 21 - 27, 26.02.2024

Betül Tokgöz , Gizem Kızılboğa Seval Yılmaz Ergani , Aykut Kından Mehmet Obut , Levent Dereli , Kadriye Yakut Yücel , Erkan Sağlam Fahri Burçin Fıratlıgil , Sadullah Özkan , Onur Kaya , Caner Çakır , Şevki Çelen , Ali Çağlar , Yaprak Ustun

https://doi.org/10.52827/hititmedj.1298037

Öz

Objective: To predict preeclampsia by the ratio of the HCG MoM value in the first and second trimester screening tests.
Material and Methods: The HCG-MoM values of 136 pregnant women with preeclampsia and 222 normatensive pregnant women used for first and second-trimester screening tests were proportioned , and the difference between the groups was examined. Numeric variables are expressed as mean ± standard deviation, median (minimum – maximum), and categorical variables as n (%).
Results: HCG MoM values were not different between the two groups and were within the accepted international values. The ratio of the free HCG MoM value in the first trimester to the intact HCG MoM value in the second trimester was significantly higher in the control group (1.06) than in the study group (0.99) (p=0.02).
Conclusion: Rating the MoM values of β-HCG, a biochemical marker used in screening tests for chromosomal anomaly, may predict preeclampsia in the later weeks of pregnancy.

Anahtar Kelimeler

Preeclampsia, HCG MoM, Screening Tests

HCG Oranı Preeklempsiyi Predikte Edermi?

Öz

Amaç: Birinci ve ikinci trimester tarama testlerindeki HCG MoM değerinin oranına göre preeklampsiyi öngörmek.
Gereç ve Yöntemler: 136 preeklampsili gebe ile 222 normal tansiyonlu gebenin birinci ve ikinci trimester tarama testleri için kullandıkları HCG-MoM değerleri oranlanarak gruplar arasındaki fark incelendi. Sayısal değişkenler ortalama ± standart sapma, medyan (minimum – maksimum), kategorik değişkenler ise n (%) olarak ifade edilmiştir.
Bulgular: İki grup arasında HCG MoM değerleri arasında fark izlenmedi ve kabul edilen uluslararası değerler içerisindeydi . Birinci trimesterdeki serbest HCG MoM değerinin, ikinci trimesterdeki intakt HCG MoM değerine oranı kontrol grubunda (1,06) çalışma grubuna göre (0,99) anlamlı olarak yüksekti (p=0,02).
Sonuç: Kromozomal anomali tarama testlerinde kullanılan biyokimyasal bir belirteç olan β-HCG'nin MoM değerlerinin derecelendirilmesi, gebeliğin ileri haftalarında preeklampsiyi öngörebilir.

Anahtar Kelimeler

Preeklempsi, ,HCG MoM, Tarama Testleri

Kaynakça

• Obstetricians ACo, Gynecologists. ACOG practice bulletin no. 202: gestational hypertension and preeclampsia. Obstet Gynecol. 2019;133:e1-e25.
• Lim R, Barker G, Lappas M. TREM-1 expression is increased in human placentas from severe early-onset preeclamptic pregnancies where it may be involved in syncytialization. Reproductive Sciences. 2014;21:562-72.
• Rolfo A, Giuffrida D, Nuzzo AM. et al. Pro-inflammatory profile of preeclamptic placental mesenchymal stromal cells: new insights into the etiopathogenesis of preeclampsia. PLoS One. 2013;8:e59403.
• Pijnenborg R, Vercruysse L, Hanssens M. The uterine spiral arteries in human pregnancy: facts and controversies. Placenta. 2006;27:939-58.
• Suri S, Muttukrishna S, Jauniaux E. 2D-ultrasound and endocrinologic evaluation of placentation in early pregnancy and its relationship to fetal birthweight in normal pregnancies and pre-eclampsia. Placenta. 2013;34:745-50.
• Cole LA. New discoveries on the biology and detection of human chorionic gonadotropin. Reproductive Biology and Endocrinology. 2009;7:1-37.
• Zhang X, Huangfu Z, Shi F, Xiao Z. Predictive Performance of Serum β-hCG MoM Levels for Preeclampsia Screening: A Meta-Analysis. Frontiers in Endocrinology. 2021;12.
• Cole LA. Biological functions of hCG and hCG-related molecules. Reproductive Biology and Endocrinology. 2010;8:1-14.
• Toldi G, Švec P, Vásárhelyi B. et al. Decreased number of FoxP3+ regulatory T cells in preeclampsia. Acta obstetricia et gynecologica Scandinavica. 2008;87:1229-33.
• Fournier T, Guibourdenche J, Evain-Brion D. hCGs: different sources of production, different glycoforms and functions. Placenta. 2015;36:S60-S5.
• Cincotta R, Brennecke S. Family history of pre‐eclampsia as a predictor for pre‐eclampsia in primigravidas. International Journal of Gynecology & Obstetrics. 1998;60:23-7.
• Abdel Moety GAF, Almohamady M, Sherif NA. et al. Could first-trimester assessment of placental functions predict preeclampsia and intrauterine growth restriction? A prospective cohort study. The Journal of Maternal-Fetal & Neonatal Medicine. 2016;29:413-7.
• Johnson M, Riddle A, Grudzinskas J, Sharma V, Collins W, Nicolaides K. The role of trophoblast dysfunction in the aetiology of miscarriage. BJOG: An International Journal of Obstetrics & Gynaecology. 1993;100:353-9.
• Di Lorenzo G, Ceccarello M, Cecotti V. et al. First Trimester Maternal Serum PlGF, Free β-hCG, PAPP-A, PP-13, Uterine Artery Doppler and Maternal History for the Prediction of Preeclampsia. Obstetrical & Gynecological Survey. 2012;67:623-4.
• Honarjoo M, Kohan S, Zarean E, Tarrahi MJ. Assessment of β-human-derived chorionic gonadotrophic hormone [βhCG] and pregnancy-associated plasma protein A [PAPP-A] levels as predictive factors of preeclampsia in the first trimester among Iranian women: a cohort study. BMC pregnancy and childbirth. 2019;19:1-5.
• Mikat B, Zeller A, Scherag A, Drommelschmidt K, Kimmig R, Schmidt M. βhCG and PAPP-A in first trimester: predictive factors for preeclampsia? Hypertension in Pregnancy. 2012;31:261-7.
• Liu H-Q, Wang Y-H, Wang L-L, Hao M. Predictive value of free β-hCG multiple of the median for women with preeclampsia. Gynecologic and Obstetric Investigation. 2016;81:137-47.
• Gomes MS, Carlos-Alves M, Trocado V, Arteiro D, Pinheiro P. Prediction of adverse pregnancy outcomes by extreme values of first trimester screening markers. Obstetric medicine. 2017;10:132-7.
• Sharony R, Sharon-Weiner M, Kidron D. et al. The association between maternal serum first trimester free βhCG, second trimester intact hCG levels and foetal growth restriction and preeclampsia. Journal of Obstetrics and Gynaecology. 2018;38:363-6.
• Rolnik DL, Nicolaides KH, Poon LC. Prevention of preeclampsia with aspirin. American Journal of Obstetrics and Gynecology. 2020.