Table 3_Early pregnancy with low β-hCG levels progressing to severe preeclampisa: a case report highlighting individualized management strategies.docx

Introductionβ-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.
ConclusionEarly 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.

引言
β-人绒毛膜促性腺激素（β-human chorionic gonadotropin, β-hCG）是由胎盘合体滋养层分泌的妊娠激素，其与胎儿生长、胎盘、子宫及胎儿功能均密切相关。早期妊娠时β-hCG水平低下与流产等病理性妊娠密切相关，其发病机制可能与胎盘绒毛发育异常有关。本研究报道1例自然受孕后早期出现β-hCG水平低下的35岁孕妇：该患者经重组人粒细胞集落刺激因子、低分子肝素及地屈孕酮保胎治疗后，于妊娠12周起每日服用阿司匹林100mg；妊娠20周时因出现显著水肿，将阿司匹林剂量调整为150mg。经个体化治疗调整后，该患者于妊娠32+4周出现重度子痫前期，经精准诊疗后实现了良好的母婴预后。
结论
因胎盘功能不佳导致的早期妊娠低β-hCG血症，可能在妊娠晚期进展为重度子痫前期。临床医师应关注此类β-hCG水平低下的妊娠女性，实施个体化用药管理，以保障母婴安全。