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.
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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)
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Chemical References |
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Topics |
- Chorionic Gonadotropin
(blood)
- Female
- Humans
- Laparoscopy
- Pregnancy
- Pregnancy, Ectopic
(blood, diagnostic imaging, surgery)
- Prospective Studies
- Salpingostomy
- Ultrasonography
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