Second-trimester maternal β-human chorionic gonadotropin level associated with subsequent development of pregnancy-induced hypertension

Objective:To determine whether maternal β-human chorionic gonadotropin(β-hCG) level in second-trimester may be associated with subsequent development of pregnancy-induced hypertension(PIH).Methods:Seven hundred and sixty-two women in mid-trimester were to have maternal urine β-hCG standardized concentrations and maternal serum β-hCG measurements.Their case histories were recorded and reviewed from mid-trimester to delivery.The relation was observed between maternal urine,serum markers and subsequent development of PIH.Results:Among 762 women,504 cases were normal pregnancies,42 cases had PIH,94 cases had premature rupture of membrane (PROM),69 cases had preterm delivery (PD),53 other cases were excluded by various reasons.The levels of maternal urine,serum β-hCG in PIH were (61.75±9.78) IU/L and (304.56±54.17) ng/mg respectively,which were higher significantly than normal pregnancy group ([20.65±7.61] IU/L and [146.34±47.81] ng/mg,P<0.05).When maternal serum,urine β-hCG levels ≥2 MOM(multiple of mean),the incidences of developing PIH were increased significantly as compared with those of β-hCG <2 MOM women.The incidence of PIH increased from 5.1% in pregnancies with urine β-hCG ≥2 MOM to 11.7% in cases with urine β-hCG ≥4 MOM.Conclusion:The elevation of maternal mid-trimester urine,serum β-hCG levels is not only an early signal for dysfunction of placenta but also a dangerous signal for development of PIH.Second-trimester maternal urine β-hCG measurement proves to be superior to serum marker in clinical prediction.

Effect of Chinese Herbal Treatment on Th1- and Th2-Type Cytokines,Progesterone andβ-Human Chorionic Gonadotropin in Early Pregnant Women of Threatened Abortion

Objective： To study the clinical effects of Prescription Zhuyun-Ⅲ （助孕3号方, ZYⅢ） on early pregnant women diagnosed as threatened abortion, and its mechanism in immunity and endocrine by determining serum Th1- and Th2-type cytokines, progesterone, and β-human chorionic gonadotropin （β-HCG）. Methods： The treatment group comprised 30 early pregnant women diagnosed as threatened abortion of deficiency syndrome of Pi （脾）, Shen （肾）, or both. The control group consisted of 20 normal early pregnant women of similar gestational age. Patients in the treatment group were administered with ZYⅢ for 4 weeks. Peripheral blood samples were collected pre- and post-treatment from both the treatment and the control groups. Serum Thl-type cytokine [interleukin-2 （IL-2）] and Th2-type cytokine [interleukin-10 （IL-10）] were determined by flow cytometry, and serum progesterone and 13-HCG were determined by ELISA. Results： （1） The treatment was effective in 26 and ineffective in 4 patients of the treatment group. Therefore, the cure percentage was 86.67%. （2） In the treatment group before the treatment, IL-2 was significantly higher, IL-10 tended to be less, and the Th1/Th2 balance shifted toward Thl compared with those in the control group. （3） After the treatment, IL-2 was decreased, IL-10 was increased, and IL-2/IL-10 was decreased. Both progesterone and β-HCG were increased. Changes of progesterone were positively correlated with changes of IL-10, whereas changes of β-HCG were negatively correlated with changes of IL-2. Conclusions： Our study suggests that ZYⅢ has an evident function of protecting the fetus, and one of its mechanisms is inhibiting the secretion of Thl cytokines, promoting the secretion of Th2 cytokines, and recovering the pathological shift of the Th1/Th2 balance. The other possible mechanism is increasing serum progesterone and β-HCG concentrations. Moreover, there are some correlations between the above two effects.

绒毛膜促性腺激素、孕酮、超声和诊刮联合检测对诊治早期异位妊娠的临床观察

目的寻找一种易掌握、可诊断早期或不典型的异位妊娠及先兆流产的方法。方法对400例尿妊娠试验阳性但超声检查未发现宫内妊娠囊者随机分为A、B两组,A组(200例)为观察组,跟踪化验血β-HCG、孕酮(P),对阴道流血过多且无继续妊娠需要者进行诊刮;B组(200例)对照组仅在等待5～7d后行腹部超声检查,如发现盆腔积液则行后穹窿穿刺以明确诊断。结果A组患者明确诊断时间平均为4d,手术率3%,平均费用1000元左右;B组诊断时间平均为10d,手术率为95%,平均费用4200元左右。结论联合检测可提高异位妊娠的早期诊断率,减少了手术率,既为有生育要求患者保留输卵管的完整性提供了保障,又为患者减轻了经济负担。

Association of the microbial culture of follicular fluid,vaginal swab and catheter tip with β-hCG IVF positive and negative

Objective:To find out the association of microbial contamination withβ-human chorionic gonadotropin(β-hCG)in-vitro fertilization(IVF)positive and negative.Methods:A total of 73 fresh IVF cycle women were included in the retrospective study.Vaginal swab culture samples were collected prior to ovum pick-up and embryo transfer.The follicular fluids were collected during ovum pick-up and catheter tip culture samples were collected after successful embryo transfer.After 14 days of the embryo transfer,women were classified intoβ-hCG IVF positive and negative.The comparative statistical analyses of aerobic microbial culture reports were done betweenβ-hCG IVF positive and negative women.Results:Out of 73 women,42(57.5%)were found to beβ-hCG IVF positive and 31(43.5%)were negative.In the aerobic culture of ovum pick-up vaginal swab,follicular fluid,embryo transplantation vaginal swab and catheter tip,Enterococcus faecalis was found to be higher compared to other bacteria(Streptococcus spp.,Candida,Escherichia coli and Klebsiella).Regarding the comparison between IVF positive and negative,the overall microbial infection rate of vaginal swab culture during ovum pick-up and embryo transplantation was found to be higher in IVF negative women than in IVF positive women(38.71%vs.28.57%);however,it was not statistically significant(P>0.05).The follicular fluid and catheter tip culture microbial infection rate was found to slightly higher in IVF positive women than in IVF negative women(54.76%vs.41.94%and 19.05%vs.9.68%,respectively),but there were not significant differences(P>0.05).Conclusions:The aerobic microbial culture reports of follicular fluid,vaginal swab culture,and catheter tip culture are not statistically significantly withβ-hCG IVF positive.

The value of PAPP-A in the diagnosis and prognosis of GTD

Objective： To investigate the value of PAPP-A （pregnancy assouated plasma protein-A） in the diagnosis and prognosis of gestational trophoblastic disease （GTD）. Methods： The serum 13-HCG （β-human chorionic gonadotropin） and PAPP-A levels of 25 normal pregnant women, 28 patients with complete hydatidiform mole and 38 patients with invasive mole were measured by enzyme linked immunosorbent assay （ELISA） during the periods of diagnosis, treatment and follow-up. Results： Compared with control group, patients with complete mole and invasive mole had higher levels of β-HCG （P 〈 0.01）. But there was no significant difference between the complete and invasive mole group （P 〉 0.05）. The PAPP-A level of complete mole group was significantly higher than that of control group （P 〈 0.01）. The PAPP-A level of invasive mole group was significantly higher than that of complete mole group and control group（P 〈 0.05）. In complete mole group, serum β-HCG and PAPP-A levels of the patients with malignant sequelae were significantly higher than those with benign sequelae （P 〈 0.05）. The β-HCG level had no relationship with the clinical stage of invasive mole. However, the PAPP-A level increased with clinical advancement of invasive mole. The levels of β-HCG and PAPP-A gradually decreased after evacuation in patients with complete moles, but maintained positive or even increased in patients with subsequent malignancy diagnosis of hydatidiform mole and invasive mole, but Conclusion： The PAPP-A level can give us some help not only in early also in the prognosis of malignant sequelae.