Prediction of Placenta Accreta Using Hyperglycosylated Human Chorionic Gonadotropin

Objectives: Hyperglycosylated human chorionic gonadotropin (hCG) is a variant of hCG. In addition, it has a different oligosaccharide structure compared to the regular hCG and promotes the invasion and differentiation of peripheral cytotrophoblast. This study aimed to measure hyperglycosylated hCG as a predictor in the diagnosis of placenta accreta. Materials and Methods: In general, 90 pregnant women were involved in this case-control study among which, 30 ladies (control group) were pregnant within the gestational age of ≥36 weeks with at least one previous caesarean section and a normal sited placenta in transabdominal ultrasound (TAU). The other 60 pregnant women (case group) were within a gestational age of ≥36 weeks at least, one previous caesarean section and placenta previa with or without signs of placenta accreta in TAU. Hyperglycosylated hCG and total hCG were measured in each group and the results of the surgery were followed up. Results: Hyperglycosylated hCG showed higher serum levels in patients with placenta accreta compared to those with placenta previa and control women. Hyperglycosylated hCG with an optimal cut point of (3) IU/L predicted placenta accreta in pregnant women with 90% specificity, 76.7% sensitivity, and 81.1% accuracy. Conclusions: The high specificity of the above approach makes it a good diagnostic tool (as a single test) for confirming placenta accreta in clinical settings. When this test is added to our established workup, its high positive predictive value makes it a suitable method within the algorithm of accreta confirmation when there is a high suspicion or insufficient evidence to the diagnosis of placenta accreta.

Hyperglycosylated hCG and Placenta Accreta Spectrum

Objective We aimed to evaluate the relationship between hyperglycosylated human chorionic gonadotropin (hCG-H) and placenta accreta spectrum (PAS) in the second and third trimesters of pregnancy. Study Design This was a case–control study of PAS and controls. hCG-H was measured in the second and third trimesters of pregnancy in women with pathologically confirmed cases of PAS and in gestational age-matched controls without PAS. We compared serum hCG-H levels in cases and controls, calculated summary statistics for diagnostic accuracy, and used receiver operating characteristic (ROC) curves to define an optimal cut-point for diagnosis of PAS using hCG-H. Results Thirty case samples and 30 control samples were evaluated for hCG-H. Mean hCG-H was lower in the case compared with control group (7.8 ± 5.9 μg/L vs. 11.8 ± 8.8 μg/L, p = 0.03). At an optimal cut-point for hCG-H of ≤7.6 μg/L, the sensitivity, specificity, positive likelihood ratios, negative likelihood ratios, and area under the ROC curve were 66.7%, 69.7%, 2.20%, 0.48%, and 0.68%, respectively. Conclusion Hyperglycosylated hCG levels in the second and third trimesters of pregnancy were lower in patients with PAS than in controls, but hCG-H showed only modest capability as a diagnostic test for PAS.

Hyperglycosylated chorionic gonadotropin – prognostic criteria development of complications of pregnancy

The objective: to assess the prognostic significance of the level of serum hyperglycosylated human chorionic gonadotropin (gHCG) reative to the development of pregnancy complications that lead to impaired fetal conditions. Materials and methods. 382 pregnant women were examined who were on the register, were hospitalized in case of complications of pregnancy and gave birth to KCMH №2 (Kiev). All pregnant women were evaluated serum gCGG in the period of 8-10 weeks gestation, evaluated the course and result of pregnancy. Results. Reduction in the level of gHCG is a marker of insufficient trophoblast invasion, which is likely to lead to the formation of placental dysfunction and the development of a variety of obstetric pathology complicating the course of pregnancy and a risk factor for antenatal loss and neonatal morbidity. The conclusion. Determination of the level of hyperglycosylated human chorionic gonadotropin in the first trimester of pregnancy will make it possible to identify pregnant women at risk for the formation of placental dysfunction and propose a set of monitoring activities aimed at early detection of violations of pregnancy and their timely removal. This helps prevent the formation of severe pathological conditions during pregnancy in both the mother and the fetus, which corresponds to the current trends in the development of medical care, namely: prediction, prevention and individual approach. Key words: hyperglycosylated chorionic gonadotrophin, complications of pregnancy, disturbed fetal condition.