Midtrimester triple test levels in women with severe preeclampsia and HELLP syndrome.
BACKGROUND
The levels of midtrimester triple test constituents are known to be altered in hypertensive disorders of pregnancy.


OBJECTIVE
Our aim was to determine whether midtrimester triple test constituent levels differ in women with severe preeclampsia and those who also develop HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome.


METHODS
A retrospective chart analysis of 106 women with severe preeclampsia for whom midtrimester triple test data were available was made. None of these patients had fetuses with abnormal karyotype, nor did they deliver infants with malformations. The levels of midtrimester maternal serum alpha-fetoprotein (MSAFP), human chorionic gonadotropin (MShCG) and unconjugated estriol (MSuE3) of 74 patients with severe preeclampsia were compared with those of 32 patients who also developed HELLP syndrome.


RESULTS
The mean MShCG was significantly higher and the mean MSuE3 was significantly lower in patients with HELLP syndrome than in those with only severe preeclampsia [1.78 multiple of the medians (MoM), standard error (SE) 0.18 vs. 1.27 MoM, SE 0.07, p=0.015 and 0.86 MoM, SE 0.05 vs. 1.04 MoM, SE 0.07; p = 0.03, respectively]. The two groups did not differ significantly with regard to MSAFP levels.


CONCLUSIONS
Unexplained high levels of midtrimester MShCG and low levels of MSuE3 may be associated with the development of HELLP syndrome in women with severe preeclampsia.
Shenhav
Simon
S
Department of Obstetrics and Gynecology, Barzilai Medical Center, The Faculty of Health Sciences, Ben-Gurion University of the Negev, Ashkelon, Israel.
Gemer
Ofer
O
Volodarsky
Michael
M
Zohav
Efraim
E
Segal
Shmuel
S
D000328:Adult; D006063:Chorionic Gonadotropin / Q000097:blood*; D004964:Estriol / Q000097:blood*; D005260:Female; D017359:HELLP Syndrome / Q000097:blood* / Q000473:pathology; D006801:Humans; D008499:Medical Records; D011225:Pre-Eclampsia / Q000097:blood / Q000473:pathology; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D012189:Retrospective Studies; D012720:Severity of Illness Index; D000509:alpha-Fetoproteins / Q000378:metabolism*
D006063:Chorionic Gonadotropin; D000509:alpha-Fetoproteins; D004964:Estriol