Update: October 2018
Human chorionic gonadotropin (hCG) is a hormone
вырабатывающийся в норме только при of pregnancy. He starts
synthesized by a fertilized egg, and after the formation
trophoblast (precursor of the placenta) – its tissues.
Therefore, the hormone is normally not detected outside of pregnancy. Speaking
о HCG, обычно подразумевают его AT-субъединицу, которая уникальна,
поэтому спутать ее с другими гормонами практически is impossible.
The determination of hCG level is an important step in the diagnosis of many
pathologies of the fetus and mother. Under the conditions discussed below
the hormone is usually dramatically reduced or dramatically lowered. AT случаях, когда
deviations from the standards are small, this analysis does not have
diagnostic value therefore
- chronic placental insufficiency
- fetal intrauterine infection
determined using other methods and analyzes.
What is HCG for?
- Prevents the disappearance of the corpus luteum pregnancy and
stimulates the synthesis of estrogen and progesterone in the first weeks
- Initiates changes in the anatomy and physiology of the body.
- Prevents maternal immunity against cells
- Стимуляция половых желез и надпочечников fetus
- Participates in sexual differentiation in male fruits
(стимулирует выработку тестостерона яичками fetus)
Determination of hCG levels during pregnancy
Human chorionic gonadotropin performs in the body a colossal
function. It is produced by a fertilized egg and allows
pregnancies develop as it launches everything necessary for
this processes. This substance prevents regression of the corpus luteum and
stimulates the synthesis of hormones (estrogen and progesterone) for
сохранения of pregnancy.
- HCG is determined in the blood plasma already 9 days after
ovulation, that is, at the time of introduction of the fertilized egg in
- During normal pregnancy, its concentration doubles every
two days, peaking at 50,000-10000 IU / l at 8-10 week
pregnancy from the last menstruation (see calculator
gestation week by week).
- Then the plasma levels of hCG begin to decline rapidly, by
half to 18-20 weeks, after which it remains stable to the end
The growth of hCG after conception
It is excreted by the kidneys, so it is excreted in the urine and
It is determined in it in the range of 30-60 days after the previous one.
menstruation, reaching a peak at 60-70 day. This is the basis
всех мочевых тестов на of pregnancy.
From the first day of delay, that is, approximately 30 days
menstruation, the hormone level is large enough to use
test strips. AT поздние сроки беременности может регистрироваться
повторный пик HCG
Previously, it was considered a variant of the norm, but this peak may have
pathological significance when it is a reaction of the placenta to
inadequacy in rhesus conflict when observed
hyperplacentosis. After родоразрешения или неосложненного аборта
after 7 days, hCG should not be detected in plasma or urine, although
usually wait 42 days before considering availability
The hCG table by week of pregnancy will help to orient in
analyzes and in time to consult a doctor with the slightest deviations:
|Gestational age||Mean value, mIU / ml||Tolerance limits, mIU / ml|
Causes of elevated levels of hCG
- Multiple pregnancy
- Хромосомные патологии и пороки развития fetus
- Trophoblastic tumors
- Acceptance of human chorionic gonadotropin for therapeutic purposes.
Causes of low levels of hCG
- Ectopic (ectopic) pregnancy
- Pregnancy and threatened abortion
- Антенатальная гибель fetus
- Some chromosomal abnormalities
HCG как маркер аномалий fetus
To control the development of the baby, every pregnant woman should
undergo prenatal screening (see first trimester screening). is he
consists of several stages, including the evaluation of ultrasound data and
уровень гормонов, в том числе и HCG
AT первом триместре, на 10-14 неделе, исследуют 2 биохимических
- PAPP-A (pregnancy-associated plasma protein A)
ATо втором триместре, на 16-18 неделе, женщина проходит тройной
- AFP (alphafetoprotein)
The data of these screenings together with the results of the ultrasound allow
evaluate the risks of having a baby with certain chromosomal
anomalies and malformations. The calculation of these risks is carried out with
учетом возраста матери, ее weights и здоровья детей от предыдущих
AT 90-е годы 20 века ученые отметили, что в крови матерей,
вынашивающих детей с синдромом Дауна, уровень HCG повышен в два и
more times. The hormone enhancement mechanism is still not exactly clear, but
namely chorionic gonadotropin is the most sensitive
marker for trisomy 21 chromosomes.
Abnormalities of the fetus, leading to changes in the level of hCG:
- Down syndrome (high hCG and low levels of other
- Edwards syndrome and Patau syndrome (low levels of hCG and other
- Turner syndrome (unchanged hCG with a decrease in other
- Severe neural tube and heart defects
In case of detection of an increased risk of anomalies, the woman
may undergo additional examinations. Confirm violations
development of the fetus with high accuracy helps invasive diagnosis.
Depending on the gestational age, different methods are used:
- chorion biopsy
It is important to remember that with unsatisfactory results
screening, including hCG levels, consultation is required
There are situations when screening is extremely difficult, and sometimes
и is impossible. This happens with multiple pregnancies. In that
In this case, the level of hCG will be increased in proportion to the number of fruits
but the individual risks for each baby will be calculated
HCG for ectopic pregnancy
Ectopic pregnancy is a condition in which
the fertilized egg attaches anywhere except
the inner layer of the uterus (endometrium). More often it is located in
fallopian tubes, less often – in the uterus, ovaries, and even on the intestines.
The danger of ectopic pregnancy is that
necessarily interrupted (except for a few cases). AT
As a result, a woman may die from abundant internal
bleeding that is very difficult to stop. But there is
�The “gold standard” of diagnostics, which allows you to put such
diagnosis and take action on time. This is an ultrasound scan at
combined with the determination of hCG in the blood of women.
When ectopic pregnancy conditions for attachment
oocytes are extremely complex, so the trophoblast secretes significantly
less chorionic gonadotropin than normal
of pregnancy. If the hormone level rises extremely slowly, do not
meets the standards for the week of pregnancy, it is necessary
an ultrasound scan with a vaginal probe to find the ovum in the uterus
or outside of it. This is most likely possible with the hCG level of
1000 IU / l. If with this amount of hormone the embryo is not found, then
laparoscopic surgery and the search for the ovum.
Signs of Ectopic Pregnancy
- abdominal pain after delayed menstruation
- soreness during vaginal examination and intercourse
- sometimes – bloody discharge from the vagina
- fainting during delayed menstruation
When the above symptoms appear, you should refer to
doctor, do an ultrasound scan and pass the hCG analysis (often in dynamics) for
исключения внематочной of pregnancy.
Fading pregnancy and antenatal fetal death
Sometimes it happens that after a delay of menstruation and
positive pregnancy test signs of pregnancy is not
come or end abruptly. AT этих случаях эмбрион погибает,
but for some reason miscarriage does not occur. AT результате уровень
human chorionic hormone that matched
pregnancy stops growing and then decreases. On ultrasound can
see an embryo without a heartbeat, or even an empty fertilized egg
(anembryonia). This condition is called frozen
Causes of missed abortion
- chromosomal abnormalities (most of the non-developing
pregnancies for up to 10 weeks)
- maternal infections (often chronic endometritis)
- anatomical defects of the uterus
- maternal coagulation disorder (thrombophilia)
If after a detected missed pregnancy in the near future
miscarriage does not occur, it is necessary to have a medical abortion
or curettage of the uterus. If pregnancy fade
repeated 2 or more times, the couple should be examined for
finding out the reasons for this condition.
If the fetus dies at a later date, it is called
antenatal death. Since in the long term the level of hCG
weeks of pregnancy are not measured, he has no diagnostic
values, although a decrease in the hormone occurs anyway.
Another pathology of pregnancy diagnosed by
estimates of hCG levels are trophoblastic tumors.
Full and partial bubble skid
With the development of normal pregnancy sperm, merging with
ovule forms a zygote in which it equally combines
maternal and paternal genetic information. But sometimes
there is a loss of “female contribution” when the chromosomes of the egg as
would be banished from the ovum. In that случае развивается
condition similar to pregnancy, but only on the basis of the paternal
genetic material. This phenomenon is called full bubble.
skidding. With partial blistering of the egg information
remains, but the information from the spermatozoon is doubled.
Both during normal pregnancy and with the bubble,
paternal chromosomes are responsible for trophoblast and formation placenta.
AT случае удвоения этих хромосом трофобласт начинает развиваться с
tremendous speed throwing into the blood in large quantities
hormones, including hCG. It is based on this diagnosis.
of this disease.
With a blistering development of a normal pregnancy is impossible,
it ends in a spontaneous abortion. But the biggest trouble
that the hyperactive trophoblast begins to invade the uterus,
then beyond, sometimes turning into a malignant tumor with
metastasis. Therefore, it is important to detect this disease in time and
Signs of blistering:
- uterine bleeding in early pregnancy
- indomitable vomiting (more painful than normal
- the size of the uterus is larger than it happens at that time
- sometimes symptoms of preeclampsia
- rarely – heart palpitations, finger trembling, loss
With such signs, it is necessary to consult a doctor;
Ultrasound and measurement of the level of hCG in the blood. During normal pregnancy
the level of this hormone rarely exceeds 500,000 IU / L, and for each
gestational age there are approximate norms. With a bubbly
skidding amount of hCG exceeds them several times.
Treatment of a skidding is to extract the entire trophoblast.
from the uterus. This can be done by scraping or other surgical
intervention. Sometimes relatively benign cystic
skid turns into a frankly malignant chorionic carcinoma.
This tumor metastasizes very quickly, although it responds well to
Indications for chemotherapy for blistering:
- the amount of hCG exceeds 20,000 IU / l one month after removal
- повышение уровня HCG после удаления blistering
- metastases to the liver, stomach, brain
Chorionic carcinoma может возникнуть не только после пузырного
skidding, but also after safe delivery or abortion. In that случае
40 days after the end of the pregnancy, the level of hCG does not fall,
and often rises. A woman may be worried about uterine bleeding.
and signs of metastases to organs. AT таких случаях лечение проводят с
using chemotherapy (methotrexate and other drugs),
surgical intervention and further observation.
Administration of human chorionic gonadotropin
On the results of the blood test for hCG, including
screenings may affect the intake of this hormone. Usually he
assigned for infertility and as a preparation stage for
Very rarely, it is taken in case of a threatened abortion in a short time.
AT любом случае, если ATы принимаете этот препарат или любые другие
hormonal drugs, be sure to notify your
When can there be a false positive result?
- As some sources indicate – COC (oral
contraceptives) may affect the analysis. This is not correct information.
Taking contraceptives does not affect the level
HCG The result of the analysis is influenced by taking the drug.
хорионического гонадотропина, обычно как этап протокола ECO.
- After родов или аборта HCG обычно падает до нормы в течение 7
days Sometimes they wait up to 42 days before making a diagnosis. If not
fell, or even began to grow, then it may be trophoblastic
- Other tumors may produce an increase in hormone in metastasis.
blistering или хорионкарциномы.
- There are other germ tissue tumors, but they rarely give
повышение HCG Therefore, if there is formation in the lungs, stomach or
brain plus high hCG, then first think about
трофобластических опухолях с metastasis.
Immunity against hCG
AT редких случаях организм женщины вырабатывает иммунитет против
chorionic hormone. The resulting antibodies to this substance are not
give a fertilized egg to normally attach in the uterus and
develop. Therefore, if 2 or more pregnant women
ended in an early spontaneous abortion, then it is worth passing the analysis on
антитела к HCG
If the results are positive, a term of 1 trimester is assigned.
treatment. It consists of glucocorticoids and low molecular weight
heparins. We must not forget that this pathology is very common
rarely, therefore, before treatment, other causes must be excluded.
бесплодия и невынашивания of pregnancy.
Determining the level of human chorionic hormone is an important step
in monitoring the health of women and babies. But this analysis should
be prescribed by a doctor, since hCG rates for weeks of pregnancy have
average value, and incorrect interpretation of the indicator
leads to gratuitous anxiety and unrest, which is extremely not
желательно во время of pregnancy.
Hello! Pregnancy test shows 2 strips,
delayed menstruation for about 3 weeks. But on the ultrasound is still not
found a gestational egg. Blood test for hCG: 7550 mIU / ml. How much more
Can I wait for the embryo to be imaged?
On modern devices, the ovum can be seen in the uterus or outside
already at a hormone concentration of more than 1000 mIU / ml. Поэтом в ATашей
situations need to immediately consult a doctor to search
solutions. ATозможно придется провести лапароскопическую операцию.
Delaying a visit to doctor can turn into an internal
bleeding after termination of ectopic pregnancy.
Risks were calculated on screening at 13 weeks gestation
almost all pathologies, they turned out high. After
biopsy of the chorionic villi was obtained karyotype of the fetus 69xxx. Offer
interrupt. Is it possible in my case a bubble skid?
Triploidy may indicate the formation of a partial cystic
drift. Since a fruit with such a set of chromosomes is not viable,
You are recommended abortion followed by ultrasound and
control of b-subunit hCG. Material received after interruption
need to send for histological examination.
After прохождения скрининга мне выдали результаты в виде
hCG and PAPP-A values. The value of human chorionic gonadotropin
slightly higher than normal. How dangerous is it?
The results of any screening should be given as
quantitative value of individual risks. For example,
- Edwards Syndrome Risk: 1: 1400
- Down Syndrome Risk: 1: 1600
- risk of Patau Syndrome: 1: 1600
- risk of neural tube defect 1: 1620
In the form in which you gave the results, determine the risks
is impossible. Contact the lab where the tests were taken, with
request calculation of individual risks.