Prediction of PIH by Maternal Serum Beta HCG Levels in the Second Trimester (13-20 Weeks) of Pregnancy

Objective To test the hypothesis that women with high serum beta-HCG levels in early pregnancy are at higher risk of developing PIH. Methods Serum beta-HCG estimation was done by CLIA method in 200 women between 13 and 20 weeks of gestation, selected randomly for this study from July 2008 to Aug 2009. Multiple of median (MOM) was calculated from charts of norms available for that week of pregnancy. They were followed till delivery for development of PIH and pregnancy outcome and results analysed statistically with Chi-square test and Z test. Results Out of 200 cases, 178 (89 %) were finally evaluated. Of whom 22 (12.36 %) cases developed PIH. Beta HCG levels were considered raised if the levels were >2MOM. 20 (83.33 %) out of 24 cases with beta HCG levels >2MOM developed PIH against 2 (1.2 %) cases out of 154 having beta HCG levels <= MOM(P value <0.001). Also, higher levels of beta HCG are associated with increased severity of PIH (P value <0.01). The sensitivity was 90.91 %, specificity was 97.44 % and positive predictive value was 83.33 %. Conclusion The study concluded that the serum beta HCG estimation at mid trimester (13-20 weeks) is a good predictor of PIH and higher levels of beta HCG are associated with increased severity of PIH.