Early and late half-life of human chorionic gonadotropin as a predictor of persistent trophoblast after laparoscopic conservative surgery for tubal pregnancy.

Abstract

BACKGROUND:

To determine if the early or late half-lives (T0.5) of human chorionic gonadotropin (hCG) can identify patients with persistent trophoblastic activity after conservative surgery for tubal pregnancy.

DESIGN:

Prospective cohort study.

SETTING:

Department of obstetrics and gynecology of a university hospital.

METHODS:

All patients with a tubal pregnancy treated by laparoscopic salpingostomy between June 1997 and September 2000 were enrolled in the study. Postoperative sequential hCG sampling was performed at days 0, 2 (+/- 1) and 7 (+/- 2) and followed until levels were undetectable. Taking the biexponential hCG declining curve as a model, we calculated the early (days 0-2) and late (days 2-7) T0.5 hCG values.

MAIN OUTCOME MEASURE:

To assess success or failure of surgical treatment.

RESULTS:

Seventy-three patients with an ectopic pregnancy were managed by conservative surgery. Early and late T0.5 allowed us to identify 2/10 and 9/10 women, respectively, with persistent trophoblast. Late T0.5 levels revealed two patients with false-positive values, but one patient showed a secondary increase in hCG after day 7 (false-negative) despite a normal late T0.5.

CONCLUSIONS:

Early and late half-lives of hCG do not identify all women at risk for persistent ectopic pregnancy. To exclude persistent trophoblast, postoperative serum hCG determination should be performed until levels are undetectable.

• Authors: Marie-Hélène Billieux, Patrick Petignat, Jean-Luc Anguenot, Aldo Campana, Paul Bischof
• Journal: Acta obstetricia et gynecologica Scandinavica (Acta Obstet Gynecol Scand) Vol. 82 Issue 6 Pg. 550-5 (Jun 2003) ISSN: 0001-6349 [Print] United States
• PMID: 12780426 (Publication Type: Journal Article)

Chemical References

• Biomarkers
• Chorionic Gonadotropin

Topics

• Adolescent
• Adult
• Biomarkers (analysis)
• Chorionic Gonadotropin (analysis, pharmacokinetics)
• False Positive Reactions
• Female
• Half-Life
• Humans
• Laparoscopy
• Predictive Value of Tests
• Pregnancy
• Pregnancy, Ectopic (pathology, surgery)
• Risk Factors
• Trophoblasts