Features of changes in hCG levels during normal and frozen pregnancy. The value of hCG for the health of the child Gestation period 8 5 weeks hCG decreases

Well, yes, of course, why prove something if you can write false information and calm down on that)

http://www.my-bt.ru/talk/post8654.html

(C) HCG decoding

Normally, during pregnancy, hCG levels gradually increase. During the 1st trimester of pregnancy, b-hCG levels increase rapidly, doubling every 2-3 days. At 10–12 weeks of pregnancy, the highest level of hCG in the blood is reached, then the hCG level begins to slowly decrease and remains constant during the second half of pregnancy.

Elina I was on the site 4 hours ago Russia, Moscow

At this period, hCG is not informative due to its slow growth (according to norms) and individuality after 8000. An ultrasound is informative.

Diagnosis of pregnancy: hCG level (calculator)

Graph of changes in hCG levels in the first 14 weeks of pregnancy

Human chorionic gonadotropin (hCG) is one of the most important indicators of the presence of pregnancy and its successful development.

HCG begins to be produced by chorion tissue after implantation of the embryo - already 6-8 days after fertilization of the egg. In the first trimester of pregnancy, hCG supports the corpus luteum and stimulates the production of the hormones progesterone and estrogen, which are necessary to maintain pregnancy. This happens until the fetus-placenta system begins to independently form the necessary hormonal background.

In the first weeks of pregnancy, hCG levels should approximately double every 2 days. As pregnancy progresses, the rate of increase in hCG levels decreases.

When the level reaches 1200 mU/ml, hCG doubles every 3-4 days (from 72 to 96 hours).

After 6000 mU/ml, doubling occurs on average every 4 days (96 hours).

HCG concentrations peak at approximately 8-9 weeks of pregnancy (~6-7 weeks from conception), then hCG levels begin to slowly decline.

During multiple pregnancies, the hCG content increases in proportion to the number of fetuses.

Reduced concentrations of hCG may indicate an ectopic pregnancy or a threat of miscarriage.

HCG is a glycoprotein consisting of two subunits - alpha and beta:

- the alpha subunit is identical to the alpha subunits of the pituitary hormones (TSH, FSH and LH); - the beta subunit (beta-hCG) of the hormone is unique.

Therefore, to accurately assess hCG levels, tests for the beta subunit of this hormone (beta-hCG) are used. Test strips for rapid diagnosis of pregnancy use, in most cases, a less specific hCG test.

Determining the level of beta-hCG in the blood allows you to diagnose pregnancy within 2 weeks after fertilization. The level of beta-hCG in the urine is 1.5-2 times lower than in the blood - the concentration of beta-hCG in the urine reaches the diagnostic level 1-2 days later than in the blood serum.

HCG norms Depending on the laboratory, hCG norms for different stages of pregnancy may differ, but they look approximately like this:

Men and non-pregnant women

Chromosomal pathologies and fetal malformations
Trophoblastic tumors
Taking human chorionic gonadotropin for therapeutic purposes

Causes of low hCG levels

Frozen pregnancy and threatened abortion
Antenatal fetal death
Some chromosomal abnormalities

HCG as a marker of fetal abnormalities

To monitor the development of the baby, every pregnant woman should undergo prenatal screening (see first trimester screening). It consists of several stages, including assessment of ultrasound data and hormone levels, including hCG.

In the first trimester, at 10-14 weeks, 2 biochemical markers are examined:

PAPP-A (pregnancy-associated plasma protein A)

In the second trimester, at 16-18 weeks, a woman undergoes a triple test:

AFP (alphafetoprotein)
estriol-A

Data from these screenings, together with ultrasound results, make it possible to assess the risks of having a child with certain chromosomal abnormalities and developmental defects. These risks are calculated taking into account the mother’s age, her weight and the health of children from previous pregnancies.

In the 90s of the 20th century, scientists noted that in the blood of mothers carrying children with Down syndrome, the level of hCG was increased twofold or more. The mechanism for increasing the hormone is still not exactly clear, but human chorionic gonadotropin is the most sensitive marker for trisomy 21 chromosomes.

Fetal abnormalities leading to changes in hCG levels:

Down syndrome (high hCG and low levels of other markers)
Edwards syndrome and Patau syndrome (low levels of hCG and other markers)
Turner syndrome (unchanged hCG but decreased other markers)
Severe neural tube and cardiac defects

If an increased risk of developing abnormalities is detected, the woman may undergo additional examinations. Invasive diagnostics helps to confirm fetal developmental disorders with high accuracy. Depending on the stage of pregnancy, various methods are used:

chorionic villus biopsy
amniocentesis
cordocentesis

It is important to remember that if screening results, including hCG levels, are unsatisfactory, consultation with a geneticist is required.

There are situations when screening is extremely difficult, and sometimes impossible. This happens during multiple pregnancies. In this case, the hCG level will be increased in proportion to the number of fetuses, but calculating the individual risks for each baby will be problematic.

HCG for ectopic pregnancy

An ectopic pregnancy is a condition in which a fertilized egg implants anywhere other than the inner layer of the uterus (endometrium). More often it is located in the fallopian tubes, less often in the uterus, ovaries, and even on the intestines. The danger of an ectopic pregnancy is that it is sure to be interrupted (with the exception of a few cases). As a result, a woman may die from profuse internal bleeding, which is very difficult to stop. But there is a “gold standard” of diagnosis, which allows you to make such a diagnosis and take timely measures. This is an ultrasound examination combined with the determination of hCG in a woman’s blood.

During ectopic pregnancy, the conditions for egg attachment are extremely difficult, so the trophoblast secretes significantly less human chorionic gonadotropin than during normal pregnancy. If the hormone level grows extremely slowly and does not correspond to the norms for the weeks of pregnancy, then it is necessary to perform an ultrasound with a vaginal sensor to find the fertilized egg in or outside the uterus. This is possible with a high probability at a hCG level of 1000 IU/l. If the embryo is not found with such an amount of hormone, then laparoscopic surgery and search for the fertilized egg are necessary.

Signs of an ectopic pregnancy

abdominal pain after missed period
pain during vaginal examination and intercourse
sometimes – bloody vaginal discharge
fainting with delayed menstruation

If the above-described signs appear, you must consult a doctor, do an ultrasound and take a hCG test (often dynamically) to rule out ectopic pregnancy.

Frozen pregnancy and antenatal fetal death

Sometimes it happens that after a delay in menstruation and a positive pregnancy test, signs of pregnancy do not occur or end abruptly. In these cases, the embryo dies, but for some reason the miscarriage does not occur. As a result, the level of human chorionic hormone, which corresponded to the gestational age, stops growing and then decreases. On an ultrasound, you can see an embryo without a heartbeat or even an empty fertilized egg (anembryony). This condition is called a frozen (non-developing) pregnancy.

Causes of frozen pregnancy

chromosomal abnormalities (most pregnancies that fail to develop before 10 weeks)
maternal infections (often chronic endometritis)
anatomical defects of the uterus
maternal blood clotting disorder (thrombophilia)

If, after a detected frozen pregnancy, a miscarriage does not occur in the near future, then it is necessary to perform a medical abortion or curettage of the uterine cavity. If pregnancy loss occurs 2 or more times, the couple needs to be examined to determine the causes of this condition.

If the fetus dies at a later stage, it is called antenatal death. Since during long periods the hCG level is not measured over the weeks of pregnancy, it has no diagnostic value, although a decrease in the hormone occurs in any case.

Trophoblastic tumors

Another pregnancy pathology diagnosed by assessing hCG levels is trophoblastic tumors.

Complete and partial hydatidiform mole

During the development of a normal pregnancy, the sperm, merging with the egg, forms a zygote, which equally combines maternal and paternal genetic information. But sometimes there is a loss of the “female contribution” when the chromosomes of the egg are, as it were, expelled from the fertilized egg. In this case, a condition similar to pregnancy develops, but only based on the paternal genetic material. This phenomenon is called a complete hydatidiform mole. With a partial hydatidiform mole, the information from the egg remains, but the information from the sperm is doubled.

Both in normal pregnancy and in hydatidiform pregnancy, the paternal chromosomes are responsible for the trophoblast and the formation of the placenta. In the case of doubling of these chromosomes, the trophoblast begins to develop at tremendous speed, releasing large quantities of hormones, including hCG, into the blood. This is what the diagnosis of this disease is based on.

With a hydatidiform mole, the development of a normal pregnancy is impossible; it ends in spontaneous abortion. But the biggest problem is that the hyperactive trophoblast begins to invade the uterus, then beyond it, sometimes turning into a malignant tumor with metastases. Therefore, it is important to detect this disease in time and begin treatment.

Signs of hydatidiform mole:

uterine bleeding in early pregnancy
uncontrollable vomiting (more painful than during normal pregnancy)
the size of the uterus is larger than it would be at this age
sometimes – symptoms of preeclampsia
rarely - rapid heartbeat, trembling fingers, weight loss

With such signs, it is necessary to consult a doctor, perform an ultrasound and measure the level of hCG in the blood. During normal pregnancy, the level of this hormone rarely exceeds 500,000 IU/l, and there are approximate norms for each stage of pregnancy. With hydatidiform mole, the amount of hCG exceeds them several times.

Treatment for hydatidiform mole involves removing all trophoblast from the uterus. This can be done by curettage or other surgical intervention. Sometimes a relatively benign hydatidiform mole turns into a frankly malignant chorionic carcinoma. This tumor metastasizes very quickly, although it responds well to chemotherapy.

Indications for chemotherapy for hydatidiform mole:

the amount of hCG exceeds 20,000 IU/l a month after removal of the hydatidiform mole
increase in hCG levels after removal of a hydatidiform mole
metastases to the liver, stomach, brain

Chorionic carcinoma

Chorionic carcinoma can occur not only after a hydatidiform mole, but also after a successful birth or abortion. In this case, 40 days after the end of pregnancy, the hCG level does not fall, but often rises. A woman may be concerned about uterine bleeding and signs of metastases to organs. In such cases, treatment is carried out with chemotherapy (methotrexate and other drugs), surgery and further observation.

Pregnancy 4D 7 weeks

Taking medications containing human chorionic gonadotropin

The results of a blood test for hCG, including during screenings, can be affected by taking this hormone orally. It is usually prescribed for infertility and as a preparation stage for IVF.

It is very rarely taken for threatened abortion at short term. In any case, if you are taking this drug or any other hormonal medications, be sure to notify your doctor.

When can a false positive test result occur?

As some sources indicate, taking COCs (oral contraceptives) can affect the analysis. This is not correct information. Taking contraceptives does not affect hCG levels. The result of the analysis is influenced by the intake of the drug human chorionic gonadotropin, usually as a stage of the IVF protocol.
After childbirth or abortion, hCG usually drops to normal within 7 days. Sometimes they wait up to 42 days before making a diagnosis. If it does not fall, or even begins to grow, then it may be a trophoblastic tumor.
Other tumors may produce an increase in the hormone in metastases of hydatidiform mole or chorionic carcinoma.
There are other tumors from germinal tissues, but they rarely give rise to hCG. Therefore, if there is a formation in the lungs, stomach or brain plus high hCG, then first of all they think about trophoblastic tumors with metastases.

Immunity against hCG

In rare cases, a woman’s body develops immunity against human chorionic hormone. The resulting antibodies to this substance prevent the fertilized egg from attaching normally in the uterus and developing. Therefore, if a woman’s 2 or more pregnancies ended in early spontaneous abortion, then it is worth getting tested for antibodies to hCG.

If the results are positive, treatment is prescribed during the 1st trimester. It consists of glucocorticoids and low molecular weight heparins. We must not forget that this pathology is very rare, so before treatment it is necessary to exclude other causes of infertility and miscarriage.

Determining the level of human chorionic hormone is an important step in monitoring the health of a woman and baby. But this analysis should be prescribed by a doctor, since hCG norms for weeks of pregnancy have an average value, and incorrect interpretation of the indicator leads to causeless anxiety and worry, which is extremely undesirable during pregnancy.

FAQ

Hello! The pregnancy test shows 2 lines, my period is already about 3 weeks late. But the ultrasound still hasn’t found a fertilized egg. Blood test for hCG: 7550 mIU/ml. How long can I wait for embryo imaging?

With modern devices, the fertilized egg is visible in the uterus or outside it already at a hormone concentration of more than 1000 mIU/ml. Therefore, in your situation, you need to immediately consult a doctor to find a solution. You may have to undergo laparoscopic surgery. Delaying a visit to the doctor can result in internal bleeding after termination of an ectopic pregnancy.

At screening at 13 weeks of pregnancy, risks were calculated; for almost all pathologies they turned out to be high. After chorionic villus biopsy, a fetal karyotype of 69xxx was obtained. They offer an interruption. Is hydatidiform mole possible in my case?

Triploidy may indicate the formation of a partial hydatidiform mole. Since a fetus with such a set of chromosomes is not viable, you are recommended to terminate the pregnancy, followed by ultrasound and monitoring of the b-subunit of hCG. The material obtained after the interruption must be sent for histological examination.

After completing the screening, I was given the results in the form of hCG and PAPP-A values. The value of human chorionic gonadotropin is slightly higher than normal. How dangerous is this?

The results of any screening should be given in the form of a quantitative value of individual risks. For example,

risk of Edwards syndrome: 1:1400
risk of Patau Syndrome: 1:1600
risk of neural tube defect 1:1620

In the form in which the results were given to you, it is impossible to determine the risks. Contact the laboratory where you took the tests and ask them to calculate your individual risks.

HCG during pregnancy

HCG (human chorionic gonadotropin) is a hormone that is secreted by the membranes of the embryo. The presence of hCG in the body indicates that the woman is pregnant. The hCG test is very important. Since it can be used to prevent spontaneous abortion (miscarriage), identify frozen pregnancy, and ectopic location of the ovum.

How to determine hCG and what its norms are

In order to check whether a woman’s blood contains human chorionic gonadotropin, you need to do a blood test, urine test, and a pregnancy test can also come to the rescue. A blood test for hCG should be taken in the morning, when the woman has not eaten anything yet. If the test is not to be taken in the morning, then you must not eat for at least four hours before it. It is best to do this test five days after the egg is implanted, before your period begins. In women who are not pregnant, the hCG level is less than 15 mU/ml. A blood test is the most accurate. It is followed somewhat lower in accuracy by urine analysis. The most unreliable is the pregnancy test, but due to the fact that it is convenient to use, it is the one most often used by women. Tests can show an accurate result from the first day of a missed period. But there are particularly sensitive tests that can show results even three days before the expected date of menstruation.

In the chart shown below, you can see how your hCG increases each week. In the first trimester of pregnancy, its growth is very rapid, and in the first weeks it doubles every 36-48 hours. At the tenth week, growth stops.

The following hCG values by week are normal:

One to two weeks, the hCG level can range from 25 to 156 mU/ml.
In the second - third week - 101 - 4870
In the fourth to fifth week, the normal level is from 2560 to 82300 mU/ml.
In the fifth - sixth week - 23100 - 151000 mU/ml.
Sixth - seventh week of pregnancy - 27300 - 233000 mU/ml.
Seventh - eleventh week - 20900 - 291000 mU/ml.
Eleventh - sixteenth week - 6140 - 103000 mU/ml.
Sixteenth - twenty-first week - 4720 - 80100 mU/ml.
Twenty-first - thirty-ninth week - 2700 - 78100 mU / ml.

What does low or high hCG indicate?

HCG indicates not only the presence or absence of pregnancy. Its level in the body can fluctuate depending on various pathological diseases of the body. This test is very often prescribed by gynecologists in order to diagnose a woman.

If a woman has low hCG levels during pregnancy, this may indicate that she has some problems associated with bearing a child. If the level of this hormone does not increase with the duration of pregnancy, then this basically means that the development of the fetus has stopped. In this case, the pilaf dies or its development stops. Most often, spontaneous abortion occurs, that is, miscarriage, but if, after detecting fetal freezing, it does not exist, then doctors prescribe curettage of the uterine cavity for the woman. Some women are diagnosed with an ectopic pregnancy. If it develops in a woman, then her tests will also show a low level of hCG. At the earliest stages of fetal development, the level of the hormone is within normal limits, and later its growth slows down. The reason for this is that the fetus is inappropriately positioned, and also because the chorion is exfoliated. In some cases, the slowdown is caused by the threat of interruption, which is caused by hormonal changes. Low hCG levels do not always indicate any disorders or diseases. Sometimes doctors may give an inaccurate gestational age due to ovulation that did not occur on time, or incorrect information about the menstrual cycle provided to the doctor by the woman.

Elevated hCG can also be diagnosed during pregnancy. In the early stages, this happens in cases where a woman is carrying two children, or even more. An increase in hCG can also be caused by early toxicosis and diabetes mellitus. If, during examination in the second trimester of pregnancy, an increased level of hCG is detected in the body, this indicates that the child may develop Down syndrome. But in this case, doctors can only make an assumption, since a hCG test alone is not enough to make this diagnosis. When labor does not come on time and a woman carries her baby to term, the level of this hormone in the body may also increase. This negatively affects the baby's health. For these reasons, testing for hCG levels is so important.

False test result

In some cases, human chorionic gonadotropin can be found in the body of a woman who is not pregnant, and sometimes in a man’s body.

Testicular teratoma and seminoma (testicular tumor in men, often malignant);
Neoplasms of the kidneys, uterus, and other organs;
First week after abortion;
Taking medications that contain human chorionic gonadotropin. Such drugs are often used by women who are preparing for IVF.

HCG analysis is used to determine pregnancy, as well as to determine frozen pregnancy, ectopic pregnancy, and also to determine certain cancer diseases.

HCG, or human chorionic gonadotropin, is a hormone that begins to be produced in significant quantities in the female body only after the embryo attaches to the wall of the uterus, which is observed around the fourth day. It is the concentration of this substance in the blood that makes it possible to determine whether pregnancy has occurred.

HCG acts as a corticosteroid, helping the expectant mother’s body to withstand stress and not perceive the embryo as a dangerous foreign body, and also affects the production of progesterone and estrogen, which allows for a normal pregnancy.

A blood test for human chorionic gonadotropin provides the most accurate early pregnancy test. All home tests are also based on this principle, but the required amount of the substance in the urine is achieved much later than the required concentration in the blood.

During normal gestation, the amount of the hormone should double every two days, and by the tenth to eleventh week of pregnancy it reaches its maximum. After this period, the concentration gradually decreases.

Normal concentrations in non-pregnant women and men are zero to five. In pregnant women, the dynamics of hCG begins to increase rapidly and then gradually decrease:

During the first trimester, the level of the substance rises rapidly - from 26 mU/ml to 300,000, which helps prevent miscarriage;
The second trimester is characterized by a slow drop in hCG levels from 300,000 to 3,000.
The third trimester allows the body to produce relatively small amounts of the hormonal substance - the concentration can range from 2500 to 78000 mU/ml.

The table for the growth of hormone concentrations in pregnant women is as follows:

Weeks of pregnancy	HCG norms, honey/ml
3-4	25 – 160
4-5	100 – 4800
5-6	1100 – 31000
6-7	2600 – 82000
7-8	23000 – 150000
8-9	27000 – 233000
9-13	21000 – 290000
13-18	6000 – 103000
18-23	4700 – 80000
23-41	2700 – 78000

HCG level too high

Any deviation from the normal concentration of the hormone in the blood is fraught with various diseases and complications. Elevated levels of the substance in the blood of non-pregnant women and men may be a sign of abnormalities that a person may have, such as:

Tumors in the testicles;
Tumors in the gastrointestinal tract;
Abnormal growths in the lungs, uterus, and kidneys;
Hydatidiform mole, in which conception occurs, but the chorionic tissue begins to form bubbles rather than a full-fledged embryo;
Chorionic carcinoma is a malignant tumor, most often formed from fetal cells (sometimes found in non-pregnant women).

Low hCG in pregnant women

Since during the normal development of pregnancy the concentration of the hormone in the blood increases rapidly in the first trimester, an absent increase in hCG in a pregnant woman can become a sign of the following pathologies:

The pregnancy turned out to be ectopic;
There is fading of pregnancy (PG);
Threat of miscarriage if hormone levels drop by more than fifty percent;
Delay in the development of the embryo or its death in the first or second trimester;
Observed placental insufficiency;
Post-term childbearing.

Elevated hCG in pregnant women

You should not think that if hCG is contained in the blood in large quantities, then this is not a sign of pathology. If a woman carrying a child has an increased level of the hormone, this may mean that:

A woman is pregnant with several children, and the amount of the hormone increases in direct proportion to the number of embryos;
The fetus may have developmental abnormalities;
The mother has diabetes mellitus;
Preeclampsia may appear - a dangerous complication of pregnancy, accompanied by convulsions and can be a cause of death among women bearing children;
A woman takes synthetic gestagen hormones.

HCG during frozen pregnancy

You should contact your doctor for additional examinations for any suspicious reason; you should especially carefully monitor the appearance of:

Bloody discharge during the first trimester of pregnancy;
Drawing unpleasant pain in the lower abdomen;
An abrupt cessation of toxicosis, especially if it was pronounced before.

If after the analysis it was noticed that hCG is not growing well, it is necessary to exclude the presence of a frozen pregnancy, in which the non-developing fetus dies after some time. Most likely, the doctor will order a test several times, during which it will be determined whether the hCG is rising.

To take the test, you need to come to the laboratory in the morning, blood is taken from a vein on an empty stomach. Most often, you need to undergo a laboratory test for fetal pathology from the fourteenth to the eighteenth week; in case of a frozen pregnancy, hCG must be taken as soon as suspicion arises, having first consulted with the doctor who is observing the patient.

In most cases, with a non-developing pregnancy, hCG does not rise; its level may drop sharply, and the rate of decline will depend on the individual characteristics of the patient’s body. For example, with normal development of the child, the hCG level from the fourth to the sixth week should rise from 20,000 to 50,000, with an abnormality the concentration of the hormone at 6 weeks. may turn out to be equal to the readings of the 4th. In some cases, the level of hCG during a frozen pregnancy may slowly increase, but any specialist will determine that the development of the fetus has stopped, since the growth rate of hCG during a frozen pregnancy is not enough to maintain it.

Most often, this situation cannot be corrected, which is why most often doctors simply recommend waiting until the frozen pregnancy ends on its own; in this case, there is not enough hCG, and when the level drops to normal for non-pregnant women, the uterus contracts and expels the fertilized egg, resulting in miscarriage.

It is impossible to answer 100% the question whether a frozen pregnancy can be resolved through a miscarriage without medical intervention. In most cases, if the problem is not resolved naturally, two methods of interruption are chosen:

Medication, which is used if the period was no more than eight weeks;
Curettage, which is performed after a period of more than eight weeks.

Tests for hCG should be carried out not only as a pregnancy test, but also as a way to determine pathologies in the development of the fetus and the process of bearing a child. If the slightest suspicious signs occur, you should consult a doctor, since in this case there may still be a possibility of continuing the pregnancy.

Bibliography

Metabolic syndrome and thrombophilia in obstetrics and gynecology. Makatsaria A.D., Pshenichnikova E.B. 2006 Publisher: MIA.
Emergency conditions in obstetrics and gynecology: diagnosis and treatment. Pearlman M., Tintinally J. 2008. Publisher: Binom. Knowledge Laboratory.
New honey technology (Methodological recommendations) “Management of premature pregnancy complicated by premature rupture of membranes”; Makarov O.V., Kozlov P.V. (Edited by Volodin N.N.) – RASPM; Moscow; TsKMS GOU VPO RGMU-2006.
Obstetrics: course of lectures. UMO stamp for medical education. Strizhakov A.N., Davydov A.I., Budanov P.V., Baev O.R. 2009 Publisher: Geotar-Media.
Obstetric tactics for breech presentation, Strizhakov A.N., Ignatko I.V., M.: Dynasty, 2009.