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Beta(β) HCG Tekrar Yükselebilir Mi?

Beta(β) HCG  Tekrar Yükselebilir Mi?

Hamileliğin erken döneminde yükselen ve önce kanda sonra idrarda tespit edilen HCG hormonu gebelik testinin pozitif çıkmasına neden olur. Bu nedenle HCG hormonuna gebelik hormonu da denebilir.
HCG hormonun yapısı ve salınımı
HCG hormonun iki alt ünitesi bulunmaktadır. Bunlar alfa (α) ve beta (β) HCG’dir. Alfa HCG hormonu kandaki LH hormonu ile çok benzediği için gebelik testinde çok spesifik sonuç vermez. Bu nedenle daha spesifik ve özel olan beta HCG hormonuna bakılır. Beta HCG hormonu daha duyarlıdır.
Yumurta hücresi tüptan aşağı doğru inerken sperm hücresi ile karşılaşır ve döllenme gerçekleşir. Döllenmenin olmasıyla beraber HCG hormonu salınımı başlar. HCG hormonu başta çok düşük düzeylerde salınmasına rağmen yumurtalığın rahim içine yerleşmesi yani implantasyonu sonucu HCG düzeyi hızla artar. 40 haftalık bir dönemi kapsayacak olan gebelik süreci de böylece başlamış olur.
HCG hormonun görevi
HCG hormonun temel görevi ilk üç ayda progesteron hormonun salınımını uyarmaktır. Progesteron hormonu ise bebeğin rahim içine yerleşerek tutunmasını sağlayan çok öenmli bir hormondur. Gebeliğin ilk döneminden itibaren salgılanır ve gebeliğin devam etmesini sağlar. Üç aylık süreç sonrası plasenta devreye girerek hormon salınımını düzenler.
Hamilelikte HCG düzeyleri
Hamilelikte yapılan tarama teslerinden ikili test 11. ve 14. hamilelik haftalarında yapılmaktadır. HCG düzeyinin yüksek çıkmasına göre bebekte oluşabilecek anormallikler önceden belirlenebilmiş olur. Üçlü test ise hamileliğin 16. ve 18. haftalarında yapılır ve HCG düzeyi normalin iki katı kadarsa Down sendromu riski var demektir. HCG düzeyi döllenmeden 8-9 hafta sonra artmaya başlar ve her hafta ikiye katlanarak devam eder. Bu artış 9. gebelik haftasına kadar ve sonra düşüşe geçer.

Normal bir hamilelikte HCG değerleri çok değişkenlik gösterir ve bu değerlere bakarak hamilelik haftasını tahmin etmek doğru olmaz. Ayrıca yine HCG değerlerine bakarak bebeğin canlılığı hakkında yorum yapamayız. Çünkü bebek ölü bile olsa HCG çok düşük düzeyde salgılanmaya devam eder. Ayrıca gebe olmayan kadınlarda da LH’ın salgıladığı çok düşük miktarda bir HCG vardır. (5-10 IU/mL civarında). Teorik olarak 10 miliinternasyonel unite/mL üzerine HCG gebeliğin olduğunun kanıtıdır.
Son Adet Tarihi       HCG (mIU/ml)
3 hafta                       10 – 50
4 hafta                       13 – 426
5 hafta                       19 – 7,340
6 hafta                       1,080 – 56,500
7 – 12 hafta               7,650 – 288,000
13 – 16 hafta             13,300 – 254,000
17 – 24 hafta             4,060 – 165,400
25 – 40 hafta            3,640 – 117,000

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