Disappearance of pregnancy-specific beta 1 glycoprotein from the maternal circulation after delivery

Ultrasound and circulating placental protein measurements in complications of early pregnancy

Maternal serum levels of human chorionic gonadotrophin (hCG), Schwangerschaftsprotein 1 (SP1) and pregnancy-associated plasma protein A (PAPP-A) were measured in an unselected group of 624 women presenting with amenorrhoea and vaginal bleeding with or without abdominal pain to an emergency gynaecological ultrasound clinic. Abdominal sector scanning was used to assess uterine contents. Pregnancy was confirmed by ultrasound in 406 pregnancies. Histological confirmation was obtained in each case of pregnancy failure. A live fetus was demonstrated in 259 women of whom six subsequently miscarried; one of these had markedly depressed serum hCG and PAPP-A, but normal SP1 levels, and two had oligohydramnios. Of the 147 women without ultrasound evidence of fetal heart action 67 had a correct ultrasound diagnosis of anembryonic pregnancy. The predictive value of a depressed serum hCG level was 70% in this group, and 31% in samples taken at less than or equal to 7 weeks. The predictive value of a normal hCG level was 96%. In 34 women missed miscarriage was diagnosed readily by ultrasound; all but five had depressed hCG and PAPP-A levels. A clinical diagnosis of a complete or incomplete miscarriage was made in 45 women and easily confirmed by ultrasound. All of them had depressed hCG, SP1 and PAPP-A levels. These results indicate that the diagnostic value of ultrasound in threatened miscarriage is often better than that of biochemical tests.

Interference of an alpha 2 component in immunological determinations of pregnancy-specific beta 1 glycoprotein in serum

Pregnancy-specific beta 1 glycoprotein (SP1-beta) was purified from human retroplacental blood by sequential anion exchange chromatography, gel chromatography and affinity chromatography. The final preparation appeared to be electrophoretically and immunochemically pure and was in particular free from any component with alpha mobility. The preparation was used as immunogen in rabbits as well as tracer and standard for radioimmunoassay and for cross- and rocket-immunoelectrophoresis. It was shown that this radioimmunoassay procedure, allowed quantitative determination of SP1-beta glycoprotein without interference by the alpha component.

Placental protein 5: disappearance from the circulation after delivery

Blood was collected from 8 women following delivery at term. The decline in serum concentrations of placental protein 5 following the delivery of the infant's head was studied for 12 h. Placental protein 5 levels fell very rapidly with a half-life of 5-39 min. In the majority of women placental protein 5 was undetectable after 12 h (i.e. less than 2 microgram/l).

Interrelationships of human chorionic gonadotropin, human placental lactogen, and pregnancy-specific beta 1-glycoprotein throughout normal human gestation

Human chorionic gonadotropin (hCG), human placental lactogen (hPL), and pregnancy-specific beta 1-glycoprotein (PSBG) were measured by radioimmunoassay in 270 samples of serum from women with uncomplicated pregnancies. All three proteins were significantly correlated with each other in individual samples of serum and with the estimated trophoblastic mass during the first trimester. No significant correlation could be demonstrated between the concentrations of hCG and PSBG in maternal serum during the second or third trimesters or between the concentrations of hCG and hPL during the second trimester. Levels of PSBG and hPL in serum were significantly correlated throughout all three trimesters. These findings suggest that the secretion of hCG, hPL, and PSBG may be regulated by similar control mechanisms during the first trimester of pregnancy. However, after this period, the factors that modulate the production of hCG differ from those that regulate the production of hPL and PSBG.