Role of Serum β-hCG and First Trimester Ultrasonographic Parameters in Predicting Mid-trimester Pregnancy Outcomes: A Prospective Cohort Study
Published: October 1, 2023 | DOI: https://doi.org/10.7860/JCDR/2023/63810.18587
Shanmuga Priya Rajamnickam, Sajeethakumari Raveendran, Saswati Tripathy, Anuradha Murugesan, Deboral Panneerselvam
1. Junior Resident, Department of Obstetrics and Gynaecology, SRM Medical College Hospital and Research Centre, SRM Institute of Science and Technology, Chengalpattu, Tamil Nadu, India.
2. Professor, Department of Obstetrics and Gynaecology, SRM Medical College Hospital and Research Centre, SRM Institute of Science and Technology, Chengalpattu, Tamil Nadu, India.
3. Professor, Department of Obstetrics and Gynaecology, SRM Medical College Hospital and Research Centre, SRM Institute of Science and Technology, Chengalpattu, Tamil Nadu, India.
4. Professor and Head, Department of Obstetrics and Gynaecology, SRM Medical College Hospital and Research Centre, SRM Institute of Science and Technology, Chengalpattu, Tamil Nadu, India.
5. Research Scholar, Department of Obstetrics and Gynaecology, SRM Medical College Hospital and Research Centre, SRM Institute of Science and Technology, Chengalpattu, Tamil Nadu, India.
Correspondence
Dr. Sajeethakumari Raveendran,
Professor, Department of Obstetrics and Gynaecology, SRM Medical College Hospital and Research Centre, SRM Institute of Science and Technology, Chengalpattu-603203, Tamil Nadu, India.
E-mail: sajeethaprabhakar@gmail.com
Introduction: One of the concerns in pregnant women is the risk of miscarriage and the psychological sequelae that follow. Screening in early pregnancy can identify future miscarriages in asymptomatic pregnancies.
Aim: To study the role of serum Beta-Human Chorionic Gonadotropin (β-hCG) doubling and ultrasonic parameters like Yolk Sac Diameter (YSD), Gestational Sac Diameter (GSD), and Crown-Rump Length (CRL) in predicting mid-trimester pregnancy outcomes.
Materials and Methods: A prospective cohort study was conducted at SRM Medical College and Hospital in Tamil Nadu, India, among 381 antenatal women between 6-10 weeks of gestation for a period of two years from December 2017 to July 2019. At baseline, parameters like serum β-hCG doubling titer at 48 hours and ultrasound parameters like YSD, GSD, and CRL were evaluated. The participants were followed-up until 20 weeks of gestation. The results were statistically analysed using sensitivity, specificity, Positive Predictive Value (PPV), and Negative Predictive Value (NPV).
Results: The mean age of the women included in the study was 25.89±4.2 years, with the majority of women belonging to the 21-29 years age group. Among the enrolled pregnant women, 347 had normal outcomes while 34 experienced pregnancy failure. The results indicated that β-hCG was the strongest predictor of pregnancy outcomes with a sensitivity of 52.9%, specificity of 100%, PPV of 100%, and NPV of 95.6%. YSD predicted loss rates with a sensitivity of 50%, specificity of 97.1%, PPV of 62.9%, and NPV of 95.2%. GSD predicted miscarriage with a sensitivity of 17.6%, specificity of 97.4%, PPV of 40%, and NPV of 92.3%. CRL predicted miscarriage with a sensitivity of 30.5%, specificity of 97.9%, PPV of 61.1%, and NPV of 93.2%.
Conclusion: β-hCG, YSD, GSD, and CRL were found to be statistically significant in predicting abnormal pregnancy outcomes. Among the four, β-hCG proved to be the best predictor.
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