This study was designed to correlate early pregnancy outcome with serum and trophoblastic culture media levels of hCG, ΑhCG, and the ΑhCG/hCG ratio. Maternal serum was obtained from 104 women with normal gestations (n = 25), ectopic pregnancies (n = 43) and spontaneous abortions (n = 36); trophoblastic tissue was obtained from 10 subjects in each group. The ΑhCG/hCG ratio was abnormally elevated in the serum of 46% of women with abortions and 26% of those with ectopic pregnancies. Tissue culture experiments confirmed the relative increase in ΑhCG levels. Deteriorating trophoblast tissue from compromised or poorly oxygenated placental implantations results in abnormally elevated ΑhCG/hCG ratios; this occurs secondary to a greater relative decrease in hCG than ΑhCG production. The clinical utility of this knowledge is under investigation.
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