Serum Beta-Human Chorionic Gonadotropin (β-hCG) Trends and Their Association With Abdominal Wound Healing After Cesarean Section: An Observational Study

Background and objective Beta-human chorionic gonadotropin (β-hCG) is an established biomarker in pregnancy assessment and in the management of trophoblastic and germ cell disorders. Beyond its classical endocrine role, β-hCG has biological relevance to inflammation, angiogenesis, endothelial function, immune regulation, and tissue remodeling, all of which are central to wound repair. The relationship between postoperative β-hCG decline and abdominal wound healing after cesarean section remains insufficiently characterized. The objective of this study was to evaluate the association between serial postoperative serum β-hCG trends and abdominal wound healing following cesarean section. Methods This hospital-based observational analytical study included 436 women undergoing elective or emergency lower-segment cesarean section. Baseline demographic, obstetric, and perioperative variables were recorded. Serum β-hCG levels were measured preoperatively, immediately postoperatively, and on postoperative days (PODs) 2, 3, 4, 5, 7, 14, and 21. Post-cesarean abdominal wound outcomes were clinically assessed and categorized as healthy or unhealthy. Comparative analysis and receiver operating characteristic curve analysis were performed. Results Mean β-hCG declined from 15,881.99 IU/L preoperatively to 143.13 IU/L on POD 21. Preoperative and immediate postoperative β-hCG levels did not differ significantly between wound groups. From POD 2 onward, women with unhealthy wounds had significantly higher β-hCG levels than those with healthy wounds (p < 0.001). POD 7 β-hCG showed excellent discrimination, with an area under the curve of 0.901. A cutoff of 1884 IU/L yielded 82.6% sensitivity and 81.2% specificity. Conclusions Slower postoperative β-hCG decline was associated with impaired abdominal wound healing after cesarean section. POD 7 β-hCG may serve as an adjunctive biomarker for early risk stratification.