Clinical follow‐up of high mid‐trimester maternal serum intact human chorionic gonadotrophin concentrations in singleton pregnancies

Mid-trimester biochemical screening of 38143 pregnancies in south-east Scotland revealed 127 cases (0·34 per cent) in which the maternal serum (MS) intact human chorionic gonadotrophin (hCG) concentration was 4 multiples of the median in singleton pregnancies (MOM). Three were lost to follow-up but in 72 (58 per cent) complications developed or there were associated fetal abnormalities. This percentage was greatest at very high hCG concentrations, 92 per cent with hCG 10 MOM (n=12) compared with 48 per cent with hCG concentrations of 4–4·99 MOM (n=69). 22 cases had an MS alpha-fetoprotein 2 MOM in addition to an MS hCG 4 MOM, and in only 3 of these was the pregnancy uneventful; 86 per cent were associated with abnormalities or pregnancy complications. Copyright © 1999 John Wiley & Sons, Ltd.