Early pregnancy with low β-hCG levels progressing to severe preeclampisa: a case report highlighting individualized management strategies

早期妊娠伴低β-hCG水平进展为重度子痫前期:病例报告强调个体化管理策略

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Abstract

INTRODUCTION: β-Human chorionic gonadotropin (β-hCG) is a pregnancy hormone secreted by the syncytiotrophoblast layer of the placenta. It is related to fetal growth as well as the placenta, uterus, and fetal function. Low β-hCG in early pregnancy is closely associated with pathological pregnancies such as miscarriage, and its mechanism may be related to abnormal development of placental villi. Here we present a 35-year-old pregnant woman who, after natural conception, had low levels of β-hCG in early pregnancy. After treatment with recombinant human granulocyte colony-stimulating factor, low molecular heparin, and dydrogesterone to maintain the pregnancy, she started taking aspirin 100 mg daily at 12 weeks of pregnancy. At 20 weeks of pregnancy, due to significant edema, the aspirin dosage was adjusted to 150 mg. After personalized treatment adjustments, she developed severe preeclampsia at 32(+4) weeks of pregnancy. After precise management, a good prognosis for both mother and baby was achieved. CONCLUSION: Early pregnancy with low β-hCG due to poor placental function may develop into severe preeclampsia in the third trimester. Clinicians should pay attention to this type of low β-hCG pregnant women, manage individualized medication, and promote maternal and infant safety.

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