title: Serum concentrations of human chorionic gonadotrophin and immunoreactive inhibin in early pregnancy and recurrent miscarriage: a longitudinal study.
abstract: Serum concentrations of immunoreactive inhibin (ir-inhibin) and human chorionic gonadotrophin (HCG) have been measured during the first trimester in a longitudinal study of pregnant women attending a recurrent miscarriage clinic. In 30 singleton pregnancies (Group 1) that continued successfully to term, the median concentration of ir-inhibin initially declined from 1,140 pg/mL at week 4-5 then rose back to comparable values between weeks 7 and 10 but to decline again to reach the significantly lower level of 840 pg/mL (p < 0.01) at week 15-16. Serum levels of HCG showed the classical profile of normal pregnancy reaching a median peak value of 65,600 IU/L (1st IRP) at week 8-9. In 7 pregnancies that miscarried but earlier had evidence on ultrasound of an active fetal heart, HCG levels in the first 9 weeks were consistently below the 10th percentile for Group 1 pregnancies (p < 0.001). Levels of ir-inhibin were also suppressed but to a lesser extent. In 6 of 7 a fetal pregnancies, HCG levels during the first 9 weeks were again markedly subnormal. The levels of ir-inhibin varied between high normal and subnormal. In none of the pregnancy groups was a correlation found between ir-inhibin and HCG concentrations. In a single pregnancy with an anencephalic fetus, while levels of ir-inhibin and HCG were not depressed, peak values were not reached until week 12. The study shows that the level of ir-inhibin in the maternal serum in early pregnancy is of little value as a prognostic indicator of pregnancy outcome. It confirms that a subnormal HCG level is a useful predictor of early pregnancy failure.
authors.affiliation: Department of Obstetrics and Gynaecology, University of Auckland School of Medicine, New Zealand.
authors.forename: J T
authors.initials: JT
authors.lastname: France
authors.forename: J
authors.initials: J
authors.lastname: Keelan
authors.forename: L
authors.initials: L
authors.lastname: Song
authors.forename: H
authors.initials: H
authors.lastname: Liddell
authors.forename: A
authors.initials: A
authors.lastname: Zanderigo
authors.forename: B
authors.initials: B
authors.lastname: Knox
mesh_terms: D000026:Abortion, Habitual / Q000097:blood* / Q000175:diagnosis; D006063:Chorionic Gonadotropin / Q000097:blood*; D005260:Female; D006801:Humans; D007265:Inhibins / Q000097:blood*; D008137:Longitudinal Studies; D011247:Pregnancy / Q000097:blood*; D011256:Pregnancy Outcome
chemical_list: D006063:Chorionic Gonadotropin; D007265:Inhibins