Serum human chorionic gonadotropin dynamics during spontaneous resolution of ectopic pregnancy.

Abstract

OBJECTIVE:

To study serum hCG dynamics in patients with ectopic pregnancy (EP) selected for expectant management.

DESIGN:

A prospective observational study.

SETTING:

Helsinki University Central Hospital, Helsinki, Finland.

SUBJECTS:

One hundred eighteen patients, who were selected for expectant management among 493 patients with EP.

INTERVENTIONS:

Patients were examined every 1 to 3 days using transvaginal sonography and serum hCG determinations until hCG values < 10 IU/L (conversion factor to SI unit, 1 IU/L = 2.93 pmol/L) were reached. Laparoscopy was performed if the patient developed abdominal pains or intra-abdominal hemorrhage as revealed by sonography.

MAIN OUTCOME MEASURE:

Serum hCG level.

RESULTS:

The median gestational age at the start of follow-up in patients with a spontaneous resolution was 44 days and in patients requiring laparoscopy was 48 days. The success rate for a spontaneous resolution was 88% when the initial hCG level was < 200 IU/L but only 25% at levels > 2,000 IU/L. In the 77 patients with a spontaneous resolution, the initial median hCG concentration was 374 IU/L (range, 20 to 10,762 IU/L) and it decreased to normal in 4 to 67 days (mean, 20 days). In the 41 patients requiring laparoscopy the median initial hCG concentration was 741 IU/L (range, 165 to 14,047 IU/L); a normal level was reached in 3 to 43 days (mean, 12 days) after operation. Follow-up period before operation was 1 to 24 days (mean, 9 days). Laparoscopy was indicated in two thirds of the patients with a serum hCG level > 64% of the initial value after 7 days of follow-up.

CONCLUSIONS:

Spontaneous resolution of EP correlated with a low and rapidly decreasing hCG level.

• Authors: J Korhonen, U H Stenman, P Ylöstalo
• Journal: Fertility and sterility (Fertil Steril) Vol. 61 Issue 4 Pg. 632-6 (Apr 1994) ISSN: 0015-0282 [Print] United States
• PMID: 8150103 (Publication Type: Journal Article)

Chemical References

• Chorionic Gonadotropin

Topics

• Chorionic Gonadotropin (blood)
• Female
• Humans
• Laparoscopy
• Pregnancy
• Pregnancy, Ectopic (blood, diagnostic imaging, surgery)
• Prospective Studies
• Salpingostomy
• Ultrasonography