Abstract: Introduction: Preeclampsia is a pregnancy specific disorder responsible for maternal and fetal morbidity and mortality. Every year approximately 70,000 women die due to preeclampsia and its complications. Exact etiology of this potentially fatal disorder remains poorly understood. Preeclampsia is a trophoblastic disorder where placental hypoxia causes hyperplasia of trophoblastic cells resulting increase hCG production. As hCG regulates the VEGF system, high serum hCG level may cause endothelial dysfunction and leads to the development of preeclampsia.
Objective: The study was designed to evaluate the association of maternal serum level of hCG with preeclampsia.
Methods: A case control study was conducted in the Department of Obstetrics and Gynecology, Institute of Child and Mother Health (ICMH), Dhaka. A total of 62 pregnant women of preeclampsia and 62 pregnant women without preeclampsia were enrolled in this study. Pregnant women at 20-40 weeks of gestation diagnosed as preeclampsia were selected as cases. Normal pregnant women matching with cases by age and gestational age were selected as control in this study. Data was collected from the study subjects who were selected on the basis of eligibility criteria. Serum levels of β-hCG were measured and compared between case and control groups. Data analysis was carried out using SPSS version 22.0. P-value less than 0.05 was considered as statistically significant.
Results: In this study, the mean systolic pressure was higher in cases (148.7±19.4 mmHg) than in control (106.4±9.5 mmHg). Similarly, the mean diastolic pressure was higher in cases (96.4±11.8 mmHg) than in control (70.8±6.7 mmHg). The association of systolic and diastolic pressure between case and control was statistically significant (p<0.001). Positive and significant correlation was observed between serum β-hCG compared with SBP (r = 0.802, p<0.001) and DBP (r = 0.773, p<0.001). Maternal serum β-hCG was higher in 20-28 weeks of gestation amongst the cases (57023.46±15970.9 IU/L) in relation to controls (21428.57±7841.8 IU/L) and slightly decreased in 29-40 weeks of gestation but still raised in cases (54224.69±18804.9 IU/L) compared to controls (13207.23±8483.3 IU/L). Overall, maternal serum beta hCG was higher in cases (54811.53±18159.3 IU/L) in comparison to the controls (15063.66±8975.7 IU/L) and was statistically significant (p<0.001).
Conclusion: Serum β-hCG levels are significantly increased in patients with preeclampsia. So raised maternal serum hCG level is associated with preeclampsia.
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