ABSTRACT
BACKGROUND: The aim of this study was to assess the usefulness of the beta subunit of hCG in cervicovaginal secretions as a biochemical predictor of spontaneous preterm delivery among pregnant women with and without preterm delivery risk.DESIGN: This was an eight-month prospective case control study of pregnant women with or without risk factors for preterm delivery. SETTING: Ifako- Ijaye General Hospital Lagos/ Lagos State University Teaching Hospital, Ikeja Lagos Nigeria. PARTICIPANTS: 150 pregnant women which consisted of 50 cases with preterm delivery risk and 100 controls without preterm delivery risk. INTERVENTIONS: A structured interviewer administered questionnaire which had been pretested, was used to collect data. Two cervicovaginal fluid samples at 26 weeks and 32 weeks were collected from each of the participants and it was quantitatively assayed using ELISA for presence of beta hCG. The participants were followed up till delivery. RESULTS: 15 participants out of the 50 cases delivered their babies preterm, while only 2 participants out of the 100 controls had preterm delivery. The 15 cases who delivered preterm had significant increase in their mean beta HCG value from 7.44±1.74 at 26 weeks to 32.6±1.32 at 32 weeks with p value<0.001. There was however no statistical difference in the mean beta HCG at 26 weeks and at 32 weeks for the control group. CONCLUSION: The concentration of beta HCG in the cervicovaginal fluid is a useful early predictor of preterm delivery especially among patients with risk factors.
Subject(s)
Uterine Cervical Diseases , Premature Birth , Fluids and Secretions , Chorionic Gonadotropin , Pregnant WomenABSTRACT
Objectives To determine whether raised levels of serum Beta Human Chorionic Gonadotrophin ( -HCG) are associated with higher grade and higher category tumors and whether in patients with raised levels of -HCG in their sera the rise (above normal range) and the fall (to normal) in -HCG levels would correspond with the presence or absence of tumors. Patients and Methods Radioimmunoassay for -HCG was performed using the sera (blood samples) obtained from 120 patients (mean age 70 years; range 20 - 95 years) with urothelial carcinoma at the time of diagnosis of the tumors and at follow-up. For control purposes a radioimmunoassay for -HCG was performed in 2 groups of patients: Group A: 30 patients with benign conditions who came for operations like hernia repair; and Group B: 70 patients who previously had had resection of urothelial tumors but who repeatedly had no evidence of recurrent tumors at review cystoscopy. Results Thirty-six of the 120 patients (30) with urothelial carcinomas had raised serum levels ( 4 IU/L) of -HCG. All 30 patients with benign conditions had normal levels ( 4 IU/L) of serum -HCG and 60 of the 70 patients who repeatedly did not have any evidence of recurrence at review had normal levels of serum -HCG. It was observed that raised serum levels of -HCG were more commonly associated with tumors of high grade and high stage. It was also observed that in patients with urothelial carcinoma and raised levels of serum -HCG the fall to normal levels ( 4 IU/L) corresponded with non recurrence of the tumor and the persistence of raised levels of -HCG or a further rise in serum levels of -HCG corresponded with persistence or recurrence of the tumor. Conclusion The results of this study may suggest that the serial measurement of serum -HCG may prove to be a useful adjunct to the follow-up of patients whose tumors are associated with raised serum levels of -HCG provided the elevation of serum -HCG is due to production by urothelial tumors