Serum β HCG and lipid profile in early second trimester as predictors of hypertensive disorders of pregnancy

Authors

  • Neetu Arora Department of Obstetrics and Gynecology, Government Medical College, Jammu, Jammu and Kashmir, India
  • Bhawna Sharma Department of Obstetrics and Gynecology, Government Medical College, Jammu, Jammu and Kashmir, India
  • Shashi Gupta Department of Obstetrics and Gynecology, Government Medical College, Jammu, Jammu and Kashmir, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20175543

Keywords:

β HCG, lipid profile, preeclampsia, predictor

Abstract

Background: Hypertensive disorders complicating pregnancy are common (5-10%) and form one member of the deadly triad, along with haemorrhage and infection that contribute greatly to maternal morbidity and mortality rates. Although overt illness rarely appears until third trimester, there are multiple indications that the disease process begin early in the pregnancy. Since years there has been a search for an early predictor of PIH so that special antenatal care can be given to these patients. This prospective study was one of the efforts to predict preeclampsia by measuring serum beta HCG levels and lipid profile in 2nd trimester of pregnancy.

Methods: This was a prospective study carried out on 200 pregnant women attending the outpatient antenatal clinic and estimating serum beta HCG and lipid profile in early second trimester.

Results: Most of the women who entered the study were in the age group of 21-30 years. Out of 200 patients, 164 remained normotensive and 36 turned out to be hypertensive. 50% of patients in the normotensive group and 75% in the hypertensive group were primigravidas indicating that primigravidas have a higher risk of developing PIH compared to multiparas. No correlation was found between the residence and occurrence of hypertension. Among 45 patients with beta HCG >40,000mIU/mL, 30 developed hypertensions, whereas, among 155 patients who had levels <40,000 mIU/mL, only 6 developed hypertension (p<0.0001). Maximum number of cases among the hypertensive group (83.33%) had serum TG levels >200 mg/dl. Among the hypertensive group, 83.4% cases had levels >250 mg/dl. A significantly higher number of hypertensive cases i.e.75% had serum VLDL >40 mg/dl. 83.4% of hypertensive patients had serum LDL >140 mg/dl. In our study, 5.5% of the cases among normotensive group had serum HDL <40 mg/dl whereas, 16.6% of cases among the hypertensive group had serum HDL <40 mg/dl.

Conclusions: Women with raised serum beta HCG and/or dyslipidemia should be carefully followed up to achieve a more favourable outcome for both mother and the fetus.

References

Cunningham, Leveno, Bloom, Hauth, Gilstrap, Wenstrom. Williams obstetrics, 23rd ed. 2008;34:706-56.

Lim K, Steinberg G. Preeclampsia. 2010 Available at http://emedicine.medscape.com/article/1476919-overview.

Dekker GA, Sibai BM. Etiology and pathogenesis of pre-eclampsia current concepts. Am J Obstet Gynecol. 1998;179(5):1359-75.

Vidyabati RK, Davina H, Singh NK, Singh W Gyaneshwar. Gyaneshwar Serum β HCG and lipid profile in early second trimester as predictors of pregnancy induced hypertension. J Obstet Gynecol India. 2010;60(1):44-50.

Sorensen TK, Williams MA, Zingheim RW, Hichok D. Elevated second trimester HCG and subsequent pregnancy induced hypertension. Am J obstet Gynecol. 1993;169:834-8.

Wenstrom KD, Owen J, Boots LR, Dubards MB. Elevated second trimester HCG levels in association with poor pregnancy outcome. Am J Obstet Gynecol. 1994;171:1038-41.

Clausen T, Djurovic S, Henriksen T. Dyslipidemia in early 2nd trimester is mainly a feature of women with early onset pre-eclampsia. Br J Obstet Gynecol. 2001;108:1081-7.

De J, Mukhopadhyay A, Saha PK. Study of serum lipid profile in pregnancy induced hypertension. Indian J Clin Biochem. 2006;21(2):165-8.

Gokdeniz R, Ariguloglu E, Bazaoglu N, Balat O. Elevated Serum HCG levels in severe pre-eclampsia. Turk J Med Sci. 2000;30:43-5.

Yousefnejad K, Moslemizadeh N. Serum beta HCG levels in diagnosis and management of preeclampsia. J Med Sci. 2008;8:722-7.

Yadav S, Gupta S. Correlation of elevated levels of maternal serum beta-hCG in pregnancy induced hypertension and pregnancy outcomes in these patients. Indian J Pathol Microbiol. 1997 Jul;40(3):345-9.

Gohil TJ, Patel PK, Gupta P. Estimation of lipid profile in subjects of preeclampsia. J Obstet Gynecol India. 2011Jul;61(4):399-403.

Gadalla F, Abd El-Salam AF, Wassif SM. Differential magnitude of high risk pregnancy in rural and urban communities in Sharkia governorate. Egypt J Comm Med. 1986;2(2):157-165.

El-Moselhy EA, Khalifa HO, Amer SM, Mohammad KI, Abd El-Aal HM. Risk factors and impacts of pre-Eclampsia: an epidemiological study among pregnant mothers in Cairo, Egypt. J Am Sci. 2011;7(5):311-23.

Gonen R, Perez R, David M. The association between unexplained second trimester maternal serum HCG elevation and pregnancy complication. Obstet Gynecol. 1992;80:83-6.

Benn PA, Donna Horne BSW, Susan BBS. Elevated second trimester maternal serum HCG alone or in combination with elevated AFP. Obstet Gynecol. 1996;87(2):217-22.

Feng Q, Cui S, Yang W. Clinical significance of beta HCG and human placental lactogen in serum of normal pregnancies and patients with pregnancy induced hypertension. Zhonghua Fu Chan Ke Za Zhi. 2000;35(11):648-50.

Onderoglu LS, Kabukcu A. Elevated second trimester HCG level associated with adverse pregnancy outcome. Int J Obstet Gynecol. 1997;56(3):245-9.

Vanden Elzen HJ, Wladimiroff JW, Cohen-overbeek TE, de Brujin AJ, Grobbee DE. Serum lipids in early pregnancy and risk of pre-eclampsia. Br J obstet Gynecol. 1996;103:117-22.

Mukherjee R, Ray CD, Chakraborty C, Dasgupta S, Chaudhury K. Clinical biomarker for predicting preeclampsia in women with abnormal lipid profile: Statistical pattern approach. Systems in medicine and biology (ICSMB), International Conference. 2010:397-401.

Downloads

Published

2017-12-25

Issue

Section

Original Research Articles