Serum human chorionic gonadotropin levels throughout normal pregnancy

Braunstein, Glenn D.; Rasor, Joan; Adler, Donald J.; Danzer, H.; Wade, Maclyn E.

doi:10.1016/0002-9378(76)90518-4

Cited by 256 publications

(88 citation statements)

References 12 publications

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“…Choosing b-hCG intervals for these frequency distributions was somewhat complicated. In early normal pregnancy, b-hCG increases logarithmically [19][20][21][22] ; it is common to speak in terms of bhCG doubling times [23][24][25] ; and initial b-hCG concentrations are roughly normally distributed on a log scale. 16 However, at the upper end of the b-hCG distribution for normal intrauterine pregnancy, the distribution is skewed unless plotted on an arithmetic scale.…”

Section: Methodsmentioning

confidence: 99%

Beta‐Human Chorionic Gonadotropin Levels and the Likelihood of Ectopic Pregnancy in Emergency Department Patients with Abdominal Pain or Vaginal Bleeding

Kohn

2003

Academic Emergency Medicine

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Strategies for diagnosing ectopic pregnancy that defer endovaginal ultrasound in women with suggestive symptoms and serum beta-human chorionic gonadotropin (bhCG) levels less than 1,500 mIU/mL ignore the increased risk of ectopic pregnancy in these patients. Objective: To quantify this increased risk by establishing and comparing the b-hCG distributions of symptomatic women with ectopic pregnancies, abnormal intrauterine pregnancies, and normal intrauterine pregnancies. Methods: The authors reviewed the records of a cohort of women who visited an urban emergency department (ED) during a 34-month period with abdominal pain or vaginal bleeding and nonzero quantitative b-hCG levels. Explicit criteria were used to determine whether the pregnancy ultimately turned out to be intrauterine and normal, intrauterine and abnormal, or ectopic. Probability distributions were compared using frequency distributions, receiver operating characteristic (ROC) curves, and likelihood ratios. Results: Of 730 ED patients included in the analysis, 96 (13%) had ectopic pregnancies, 253 (35%) had abnormal intrauterine pregnancies, and 381 (52%) had normal intrauterine pregnancies. The b-hCG distributions of patients with ectopic pregnancies and abnormal intrauterine pregnancies were similar and much lower than the b-hCG distribution of patients with normal intrauterine pregnancies. A b-hCG level less than 1,500 mIU/mL more than doubled the odds of ectopic pregnancy (likelihood ratio ¼ 2.24). Of the 158 patients with b-hCG below 1,500 mIU/mL, 40 (25%; 95% confidence interval [CI] ¼ 19% to 32%) had ectopic pregnancies, and only 25 (16%; CI ¼ 11% to 22%) had normal intrauterine pregnancies. Conclusions: In women with pain or bleeding and serum b-hCG levels less than 1,500 mIU/mL, the risk of ectopic pregnancy is substantially increased, while the likelihood of normal intrauterine pregnancy is low.

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Section: Methodsmentioning

confidence: 99%

Beta‐Human Chorionic Gonadotropin Levels and the Likelihood of Ectopic Pregnancy in Emergency Department Patients with Abdominal Pain or Vaginal Bleeding

Kohn

2003

Academic Emergency Medicine

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“…It may also be linked to the trophoblast response to the hypoxia as a result of a hypersecretory state. 5 The goal of this study is to evaluate the serum beta hCG levels in pregnant women as a predictor of gestational hypertension.…”

Section: Introductionmentioning

confidence: 99%

Serum beta hCG in early second trimester as a predictor of gestational hypertension

Rajesh

Muralidharan

2018

Int J Reprod Contracept Obstet Gynecol

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Background: Hypertensive disorders of pregnancy complicate upto 10% of pregnancies worldwide, and constitute one of the greatest causes of maternal and perinatal morbidity and mortality. The goal of this study is to evaluate the serum beta hCG levels in pregnant women as a predictor of gestational hypertension. Methods: This is a prospective study done at K. S. Hegde Medical Academy during the month of November 2015 to January 2017. Serum beta hCG was estimated between 14-20 weeks of gestation in 90 women with singleton pregnancy irrespective of parity. Regular follow up of the cases were done till delivery. Results were analysed statistically. Results: Out of 90 women, 81 women were followed till term and 12 (14.8%) cases developed gestational hypertension. β HCG levels (Mean±SD) were higher (69808.66±54764.7 vs. 38126.49±97419.2; p<0.28) in subjects who developed gestational hypertension. Serum beta hCG (median >32726 mIU/ml) has a sensitivity of 75%, specificity of 72.5% and accuracy of 72.8%. Conclusions: Our study indicate an increased risk of gestational hypertension in women with elevated levels of serum beta hCG. As yet there are no practically acceptable and reliable screening tests for gestational hypertension, serum beta hCG seems to be good noninvasive early predictor for the development of gestational hypertension.

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“…Immediately after fertilization, hCG is produced by the blastocyst and later by the syncytiotrophoblast (7,8). After reaching its maximum level between the 9th and 12th weeks of pregnancy, hCG concentrations decline until birth (9). In addition to its main function in stimulating P production by the corpus luteum, hCG has been described to facilitate trophoblast invasion (10)(11)(12), support angiogenesis, and ensure nourishment of the fetus (13)(14)(15).…”

mentioning

confidence: 99%

Human Chorionic Gonadotropin as a Central Regulator of Pregnancy Immune Tolerance

Schumacher

Heinze

Witte

et al. 2013

The Journal of Immunology

142

138

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Normal pregnancy is characterized by an early expansion of regulatory T cells (Tregs), which is known to contribute to fetal tolerance. However, mechanisms and factors behind Treg expansion are not yet defined. Recently, we proposed that the pregnancy hormone human chorionic gonadotropin (hCG) efficiently attracts human Tregs to trophoblasts, favoring their accumulation locally. In this study, we hypothesized that hCG not only acts as a chemoattractant of Tregs but also plays a central role in pregnancy-induced immune tolerance. Virgin, normal pregnant, and abortion-prone female mice were treated either with 10 IU/ml hCG or PBS at days 0, 2, 4, and 6 of pregnancy. The hCG effect on Treg frequency and cytokine secretion was determined in Foxp3gfp females. hCG impact on Treg suppressive capacity was studied in vitro. In vivo, we investigated whether hCG enhances Treg suppressive capacity indirectly by modulating dendritic cell maturation in an established mouse model of disturbed fetal tolerance. Application of hCG increased Treg frequency in vivo and their suppressive activity in vitro. In females having spontaneous abortions, hCG provoked not only an augmentation of Treg numbers, but also normalized fetal abortion rates. hCG-generated Tregs were fully functional and could confer tolerance when adoptively transferred. hCG also retained dendritic cells in a tolerogenic state that is likely to contribute to both Treg expansion and prevention of abortion. Our results position hCG in a novel, so far unknown role as modulator of immune tolerance during pregnancy.

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Serum human chorionic gonadotropin levels throughout normal pregnancy

Cited by 256 publications

References 12 publications

Beta‐Human Chorionic Gonadotropin Levels and the Likelihood of Ectopic Pregnancy in Emergency Department Patients with Abdominal Pain or Vaginal Bleeding

Beta‐Human Chorionic Gonadotropin Levels and the Likelihood of Ectopic Pregnancy in Emergency Department Patients with Abdominal Pain or Vaginal Bleeding

Serum beta hCG in early second trimester as a predictor of gestational hypertension

Human Chorionic Gonadotropin as a Central Regulator of Pregnancy Immune Tolerance

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