TO PREDICT PIH BY STUDYING MIDTRIMESTER SERUM BETA HCG AND ALFA FETOPROTEIN AND ITS ROLE IN FETO–MATERNAL OUTCOME

Dr.Gurcharan Kaur; Dr. Himanshi Sharma

Volume : VII, Issue : III, March - 2017

TO PREDICT PIH BY STUDYING MIDTRIMESTER SERUM BETA HCG AND ALFA FETOPROTEIN AND ITS ROLE IN FETO–MATERNAL OUTCOME

Dr. Gurcharan Kaur, Dr. Himanshi Sharma

Abstract :

Background: PIH is the most common cause of feto–maternal morbidity and mortality worldwide. The objective of this study was to determine the predictive value of mid–trimester serum beta–HCG and Alfa fetoprotein in PIH and its Fetomaternal outcome. Method: A total 200 women, fulfilling the inclusion and exclusion criteria between 12– 24 week of gestation were enrolled, whose serum beta HCG and alfa fetoprotein values were determined by radioimmunoessay at enrollment and their multiple of medians were calculated, values>2MoM were considered raised. They werefollowed till delivery for the PIH development andwere categorized into PIH and normotensive group and fetomaternal outcomes were measured in respective groups. Results:Out of 200 patients taken, 14 had spontaneous abortion, only 178 were followed for outcome measurement. Of 178 patients, 31(17.5%) developed PIH and 147(82.5%)remained normotensive. In PIH group mean value of serum beta HCG and S.AFP was 68472.29 ± 15018.87 and 119.36 ± 36.88 respectively whereas in normotensives it was27728.61 ± 5689.66 and 40.26 ± 11.09 respectively.29(93.5%) out of 31 PIH patients had beta HCG >2MoM whereas Only 3(2%) out of 147 normotensive patients had beta HCG value >2MoM making sensitivity and specificity of >2MoM beta HCG in PIH prediction is 93.5% and 97.96% respectively. Similarly,26(83.9%) out of 31 PIH patients have S.AFP >2MoM whereas Only 3(2%) of normotensive patients have S.AFP value >2MoM making sensitivity and specificity of >2MoM S.AFP in PIH predictionis 83.8% and 97.9% respectively. Maternal complication auption (9.6%), preterm labor (22.5%), post–partumhemorrhage (22.58%),oligohydramnios (22.5%), derangedDoppler (9.68%) were higher in PIH group.Still birth (3.23%) and IUD (6.45%), IUGR (25%), were higher in PIH group. Conclusion:Our study concludes that if second trimester serum beta HCG and serum AFP values were >2MoM, it was associated with development of PIH and poor fetomaternal outcome.