Elevated second trimester maternal serum β‐HCG concentrations and subsequent adverse pregnancy outcome

Abstract

Previous studies have found an association between elevated second trimester maternal serum α‐fetoprotein (MS‐AFP), in the absence of fetal anomalies, and adverse pregnancy outcome. We studied the association between elevated second trimester maternal serum β‐HCG, now also routinely measured by prenatal screening programs, and adverse pregnancy outcome by reviewing retrospectively the pregnancy outcomes among women with markedly elevated midtrimester β‐HCG in our prenatal screening program. Seven (0.23%) of 3,000 consecutively screened women had a serum β‐HCG above 5 MOM. Four (57%) of these 7 women had an adverse pregnancy outcome including severe preeclampsia (n = 2), abruptio placentae (n = 1), or preterm labor (n = 1). A concurrently elevated MS‐AFP was found in only one of these 4 patients. Elevated midtrimester maternal serum β‐HCG may be an independent risk factor for subsequent adverse pregnancy outcomes.