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Human chorionic gonadotropin is a glycoprotein composed of 237 amino acids with a molecular mass of 36.7 kDa, approximately 14.5kDa αhCG and 22.2kDa βhCG. [4]It is heterodimeric, with an α (alpha) subunit identical to that of luteinizing hormone (LH), follicle-stimulating hormone (FSH), thyroid-stimulating hormone (TSH), and a β (beta) subunit that is unique to hCG.
In anembryonic pregnancy, levels of the pregnancy hormone human chorionic gonadotropin (hCG) typically rise for a time, which can cause positive pregnancy test results and pregnancy symptoms such as tender breasts. [2] [7] Because of the presence of hCG, an ultrasound is typically necessary to diagnose an anembryonic pregnancy. [3]
The presence of hCG in a woman's body indicates that a fertilized egg has implanted in the uterus and the placenta has started to form. 10 days after fertilization, significant hCG can be detected from woman's blood sample. [6] The levels of hCG in the body increase rapidly in the first few weeks of pregnancy, doubling every 48–72 hours. [7]
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For example, for a starting hCG level of 1,500 mIU/ml or less, the hCG of continuing, normal pregnancy will increase at least 49% in 48 hours. However, for pregnancies with a higher starting hCG, between 1,500 and 3,000 mIU/ml, the hCG should rise at least 40%; for a starting hCG greater than 3,000 mIU/ml, the hCG should increase at least 33%. [30]
The increase in kidney clearance during pregnancy causes more iodide to be excreted and causes relative iodine deficiency and as a result an increase in thyroid size. Estrogen-stimulated increase in thyroid-binding globulin (TBG) leads to an increase in total thyroxine (T4), but free thyroxine (T4) and triiodothyronine (T3) remain normal. [5]
An elevated level of stress during pregnancy leads to notorious pregnancy outcomes, including preterm birth, low birth weight, and mental health problems for the mother. Prolonged effects of chronic stressors such as discrimination, intimate partner violence, housing issues, and poverty lead to widespread maternal health issues and adverse ...
An hCG ratio of 0.87, that is, a decrease in hCG of 13% over 48 hours, has a sensitivity of 93% and specificity of 97% for predicting a failing pregnancy of unknown location (PUL). [5] The majority of cases of ectopic pregnancy will have serial serum hCG levels that increase more slowly than would be expected with an IUP (that is, a suboptimal ...