Human chorionic gonadotropin?

Human chorionic gonadotropin?

Human chorionic gonadotropin is actually what we often call HCG. HCG is a sign used to diagnose whether a woman is pregnant or not. HCG is also used to diagnose pregnancy-related diseases. If the fertilized egg implants in the uterus and forms an embryo, the placenta will produce a large amount of human chorionic gonadotropin during the development of the fetus. If the pregnancy is within 2 weeks, HCG levels in the human urine and blood will increase. Therefore, human chorionic gonadotropin is used clinically to detect early pregnancy in women.

Clinical significance of human chorionic gonadotropin

1. Diagnosis of early pregnancy:

HCG can rise to greater than 2500IU/L 35 to 50 days after pregnancy. It can reach 80,000 IU/L in 60 to 70 days. The urine HCG level in multiple pregnancies is often higher than that in single pregnancies.

2. Determination of abnormal pregnancy and placental function:

① Ectopic pregnancy: In the case of ectopic pregnancy, this test has only a 60% positive rate. HCG may still be positive 3 days after uterine bleeding, so HCG examination can be used to differentiate it from other acute abdominal diseases. HCG is usually 312-625 IU/L.

② Diagnosis and treatment of miscarriage: In case of incomplete miscarriage, if there is still placental tissue remaining in the uterus, the HCG test may still be positive. In case of complete miscarriage or stillbirth, the HCG test will turn from positive to negative, so it can be used as a reference for fetal preservation or uterine aspiration treatment.

③ Premature miscarriage: If HCG levels in urine remain high, miscarriage will not occur. If HCG is below 2500IU/L and gradually decreases, there is a possibility of miscarriage or stillbirth. When it drops to 600IU/L, miscarriage is inevitable. During the treatment to preserve pregnancy, if HCG continues to decrease, it means that the pregnancy preservation is ineffective. If HCG continues to rise, it means that the pregnancy preservation is successful.

④ 4 days after delivery or 13 days after artificial abortion, serum HCG should be lower than 1000IU/L, and 9 days after delivery or 25 days after artificial abortion, serum HCG should return to normal. If this situation is not met, the possibility of abnormality should be considered.

3. Diagnosis and treatment monitoring of trophoblastic tumors

① The HCG level in the urine of patients with hydatidiform mole, malignant hydatidiform mole, choriocarcinoma and testicular teratoma is significantly elevated, which can reach 100,000 to millions of IU/L. It can be diagnosed by dilution test. For example, the urine diluted at 1:500 is positive before 12 weeks of pregnancy, and the urine diluted at 1:250 is positive after 12 weeks of pregnancy, which is valuable for the diagnosis of hydatidiform mole. A positive urine test at a dilution of 1:100 to 1:500 also has diagnostic value for choriocarcinoma. If HCG levels in male urine are elevated, testicular tumors such as seminoma, malformations, and ectopic HCG tumors should be considered.

② For patients with trophoblastic cell tumors, urine HCG should be <50IU/L 3 weeks after surgery and be negative for 8 to 12 weeks; if HCG does not decrease or does not turn negative, it indicates that there may be residual lesions. Such cases are often prone to recurrence, so regular examinations are required.

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