Elevated serum levels of interleukin-15, interleukin-16, and human chorionic gonadotropin in women with preeclampsia.

OBJECTIVES: We sought to investigate the relationship between serum levels of interleukin 15 (IL-15), interleukin 16 (IL-16), and human chorionic gonadotropin (beta-hCG) in women with a normal pregnancy and with preeclampsia, and their association with disease severity. We also wished to calculate the accuracy of these markers in diagnosing the disease and predicting its severity. MATERIALS AND METHODS: The study was conducted at Al Fayoum University in Cairo between December 2006 and September 2007. Thirty-two primigravid women with preeclampsia (preeclamptic group) scheduled for Caesarean Section were recruited and matched for age and duration of pregnancy with 35 normotensive primigravid women (control group). Of the preeclamptic women, 18 had severe preeclampsia, and 14 had mild preeclampsia. Blood sampling was performed for assays of serum IL-15, IL-16, and beta-hCG. RESULTS: Serum concentrations of IL-15, IL-16, and beta-hCG were significantly greater in preeclamptic women than in normotensive pregnant women (P < 0.001). Moreover, they were significantly higher in women with severe preeclampsia than in mild cases (P < 0.001). There was a positive correlation between serum IL-15, IL-16, and beta-hCG among all groups. The sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy of serum beta-hCG in predicting preeclampsia were 56.25%, 91.43%, 85.71%, 69.57%, and 74.63%, respectively. These values for IL-15 were 94.44%, 89.8%, 77.27%, 97.78%, and 91.04%, respectively, and for IL-16, the values were 88.89%, 95.92%, 88.89%, 95.92%, and 94.03%, respectively. CONCLUSION: Serum levels of IL-15, IL-16, and beta-hCG were significantly increased in preeclamptic women compared with normotensive women, and these levels correlated with disease severity. However, serum IL-15 and 16 had a greater overall accuracy than beta-hCG in diagnosing severe preeclampsia.

Endometrial thickness and serum beta-hCG as predictors of the effectiveness of oral misoprostol in early pregnancy failure.

OBJECTIVE: To evaluate ultrasonographic measurement of endometrial thickness and serum levels of chorionic gonadotropin (beta-hCG) as predictors of failure to abort completely in patients designated for uterine evacuation using oral misoprostol. METHODS: Women attending an obstetric outpatient clinic who complained of residual vaginal bleeding 15 days or more after taking oral misoprostol for medical induction of abortion for early pregnancy failure were evaluated by transvaginal ultrasound scan and assay of serum beta-hCG. They subsequently underwent dilatation and curettage under general anaesthesia. According to the results of histopathological examination of uterine contents, the study cohort was divided into women with incomplete abortion (19 cases, 19.6%) and cases with complete abortion (78 cases, 80.4%). The results of the ultrasound scan and the assay of serum beta-hCG were correlated with the histopathological results to determine the accuracy of these markers in predicting complete abortion. RESULTS: Baseline characteristics for both groups were similar. The endometrial thickness in the two groups ranged from 11.2 +/- 3.9 mm in the complete abortion group to 14.6 +/- 6.1 mm in the incomplete abortion group, a statistically significant difference (P = 0.003). Serum beta-hCG levels were statistically different in the two groups (complete abortion 73.9 +/- 23.9 IU/L vs. incomplete abortion 109.4 +/- 68.4 IU/L, P < 0.001). Measured endometrial thickness > or = 12 mm predicted incomplete abortion with a sensitivity of 88.5%, a specificity of 73.7%, a positive predictive value (PPV) of 93.2%, and a positive likelihood ratio (LR+ve) of 85.6. A serum beta-hCG > or = 100 IU/L predicted incomplete abortion with a sensitivity of 87.2%, a specificity of 78.9%, a PPV of 94.4%, and a LR+ve of 85.6. CONCLUSION: Quantitative assay of serum beta-hCG and ultrasound measurement of endometrial thickness are clinically useful measures for predicting late failure of medical abortion, but should be used as supplements to clinical assessments.