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Am J Perinatol 2019; 36(01): 022-026
DOI: 10.1055/s-0038-1636501
SMFM Fellowship Series Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Hyperglycosylated hCG and Placenta Accreta Spectrum

Brett D. Einerson
1   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah
2   Intermountain Healthcare, Salt Lake City, Utah
,
Alli Straubhar
3   Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah
,
Sean Soisson
4   Division of Genetic Epidemiology, Department of Internal Medicine, University of Utah Health, Salt Lake City, Utah
,
Kathryn Szczotka
3   Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah
,
Mark K. Dodson
5   Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah
,
Robert M. Silver
1   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah
2   Intermountain Healthcare, Salt Lake City, Utah
,
Andrew P. Soisson
5   Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah
› Author Affiliations
Further Information

Publication History

14 August 2017

26 January 2018

Publication Date:
28 February 2018 (online)

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Abstract

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.

Keywords

hyperglycosylated hCG - biomarkers - placenta accreta spectrum - pregnancy
 

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