title: Unexplained elevated serum hCG is associated with raised amniotic fluid erythropoietin levels in second-trimester pregnancies.
abstract: OBJECTIVE
  This study was designed to investigate the association between the concentrations of maternal serum hCG and amniotic fluid erythropoietin during the second trimester of pregnancy.
  
  
  METHODS
  In a prospective case-control study, 42 consecutive singleton pregnancies showing unexplained elevated serum hCG concentrations (>2.0 multiples of the median, MoM) in Down's syndrome screening and 27 control pregnant women undergoing midtrimester amniocentesis because of a previous cytogenetic abnormality were studied.
  
  
  RESULTS
  The mean amniotic fluid erythropoietin concentration in the study group was 1.8 (range 0.61-8.7) MoM, whereas it was 1.1 (range 0.71-3. 96) MoM in the controls (p = 0.035). A significantly increasing relationship (p < 0.05) was found between the concentrations of maternal serum hCG and amniotic fluid erythropoietin.
  
  
  CONCLUSIONS
  The results of the current study revealed in vivo the association between elevated hCG and amniotic fluid erythropoietin levels which, in turn, supports the concept of early placental damage. The underlying pathology seems to be sufficient to cause an erythroblastic response.
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital of Kuopio, Finland. seppo.heinonen@kuh.fi
authors.forename: S
authors.initials: S
authors.lastname: Heinonen
authors.forename: C
authors.initials: C
authors.lastname: Breymann
authors.forename: M
authors.initials: M
authors.lastname: Ryynänen
authors.forename: K
authors.initials: K
authors.lastname: Gautschi
authors.forename: R
authors.initials: R
authors.lastname: Huch
authors.forename: A
authors.initials: A
authors.lastname: Huch
authors.forename: P
authors.initials: P
authors.lastname: Kirkinen
mesh_terms: D000328:Adult; D000653:Amniotic Fluid / Q000378:metabolism*; D016022:Case-Control Studies; D006063:Chorionic Gonadotropin / Q000097:blood*; D015331:Cohort Studies; D004921:Erythropoietin / Q000378:metabolism*; D005260:Female; D006801:Humans; D009994:Osmolar Concentration; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000378:metabolism*; D011262:Pregnancy Trimester, Second; D011446:Prospective Studies; D012016:Reference Values
chemical_list: D006063:Chorionic Gonadotropin; D004921:Erythropoietin