Perbedaan Kadar Hyperglycosylated- HCG Serum pada Placenta Accreta Spectrum Disorder (PASD) dengan Kehamilan Normal di RSUP H Adam Malik dan RS Jejaring Medan

Abstract

Background: Placenta Accreta Spectrum Disorder (PASD) is a condition of excessive invasion of the placenta, with a high incidence rate due to the increasing number of deliveries by caesarean section. Invading extravillous trophoblast will produce a form of hyperglycosylated hCG (hCG-H), which is considered to be a marker of trophoblast invasion. This study aims to show the difference in hCG-H in pregnancies with PASD disorders compared to normal pregnancies at H. Adam Malik hospital and Network hospital medan. Method: This research is an observational analytical study with a case-control design conducted in Laboratorium Clinical Pathology Instalation H. Adam Malik General Hospital from May – June 2023. The diagnosis of PASD was obtained through an ultrasound examination and the results of FIGO intraoperative. Hyperglycosylated human chorionic gonadotropin (hCG-H) measurement using HCG-H Elisa Kit. Bivariate analysis uses the T-dependent test, whereas if the data is not normally distributed, the Mann-Whitney test is used. Result: Mean HCG-H levels in pregnant women with Placenta Accreta Spectrum Disorder (PASD) and normal pregnant women is 909,108 ± 323,106 and 198,718 ± 287,595, respectively. The analysis results showed that there was a significant HCG-H levels difference between patients with PASD and normal pregnancies (p<0.001). Discussion: From the results of this study, it was found that there was a significant difference in hCG-H levels between patients with PASD and normal pregnancies. This is possibly due to a relationship between vascularization defects in the uterine scar tissue area and the presence of hypoxic conditions which will cause the trophoblast to become continuously invasive, leading to the PASD which increased of hCG-H in PASD will influence cytotrophoblast growth and myometrial tissue invasion.