Authors : Prithu Bandyopadhyay, Vasundhara Singh
DOI : 10.18231/j.ijogr.2020.104
Volume : 7
Issue : 4
Year : 2020
Page No : 482-487
Background: Among the various causes of maternal morbidity and mortality preeclampsia/eclampsia ranks third along with haemorrhage and sepsis claiming the first two spots of the deadly triad; accounting for 63,000 direct maternal deaths worldwide (13% of all direct causes) with more than 4 million cases per year.
Alpha-fetoprotein (AFP) is the most abundant plasma protein found in the human foetus. It is produced by foetal liver and GI tract. In preeclampsia there is poor placentation due to trophoblastic dysfunction.
This causes increased leakage of this foetal protein into maternal blood leading to its increased level in the maternal serum. b -hCG and Inhibin-A are secreted from the foetal syncytiotrophoblasts. In preeclampsia due to dysfunction of these trophoblastic cells there is increased level of these proteins in maternal serum.
Aim of this present study is to analyse the potential clinical use of these biochemical (serum b -hCG, AFP, Inhibin-A) for the purpose of prediction of preeclampsia.
Materials & Methods: Study area: Medical College Hospitals, Eden Hospital, Department of Obstetrics and Gynaecology. Study population: Pregnant women attending antenatal clinic at 12-14 weeks of gestation. Inclusion criteria: Normotensive patient with singleton pregnancy at 12-14 weeks gestation.
Study Period: 1st July 2013 to 30th June 2014.Sample size: 200 Sample design: Purposive sampling. The statistical software SPSS version 20 has been used.
Result: Analysis of the results showed- 15 of the total 200 patients developed preeclampsia. Thus incidence was 7.5%. Consistent with previous studies, that stated incidence of 2-8%. Regarding the screening tests, first the cut-off values for comparison were set by constructing ROC (receiver operating characteristic) curves for each test and then they were compared for determination of predictive values of each test, as there
is no standardized cut off for these tests. Serum parameters done between 12-16 weeks of pregnancy yielded the following data: MS AFP was found raised above the cut off (cut off 2.158 MOM) in 39 subjects; of them 10 subjects developed preeclampsia. The sensitivity, specificity, PPV and NPV of AFP for prediction of preeclampsia were 66.67%, 84.32%, 25.64% and 96.89%. MSb -hCG was found raised above cut off (cut off 2.499 MOM) in 40 subjects; of them 12 subjects developed preeclampsia. The sensitivity, specificity, PPV and NPV of b -hCG for prediction of preeclampsia were 80.00%, 84.86%, 30.00%.
Keywords: Preeclampsia, AFP, HCG, Inhibin A.