Aims and objectives: To study role of PAPP-A and Beta HCG in early pregnancy for prediction of hypertensive disorders of pregnancy and intra uterine fetal growth restriction later in pregnancy. Materials and methods: This prospective cohort study was conducted in the Deptt. Of obstetrics and gynecology Safdarjung hospital which is a tertiary care centre over a period of 6 months from January 2017 to June 2017.After taking due consent, maternal serum Beta HCG and PAPP-A was measured in the antenatal women coming for routine antenatal visit between 11-14 weeks of gestation, the test value was noted down. Normal range of PAPP-A and Beta HCG levels were taken as 0.003 MOM and 0.879 mom as per previous studies. These women were followed up until delivery and looked for development of pregnancy induced hypertension (PIH) fetal growth restriction (FGR) and low birth weight (LBW). Outcome record for women developing PIH, FGR and LBW were matched with their respective first trimester biochemical markers. Results: We found out that sensitivity of serum Beta HCG estimation as a predictor of pre-eclampsia is only 33.33% and specificity 53.53%, positive predictive value being 5.49% and negative predictive value being 90.82%. Due to low sensitivity this test may not be considered as routine screening test. The sensitivity and specificity of maternal serum PAPP-A estimation between 11-14 weeks of pregnancy as a predictor of preeclampsia is 60% and 72.97% respectively. Positive predictive value of maternal serum PAPP-A is 15.25% but negative predictive value is as high as 95.74%. Conclusion: Between 11- 14 weeks of pregnancy, Serum PAPP-A levels could be used for predicting pregnancy outcomes of PIH and FGR while beta hcg measured during this period does not play any significant role. The advantage of predicting PIH in early pregnancy is that it allows early intervention of low dose aspirin in pregnant women with low serum PAPP-A levels for subsequent prevention of PIH.
