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Fertil Steril. 1994 Apr;61(4):632-6.

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

Author information

1
Department I of Obstetrics and Gynecology, Helsinki University Central Hospital, Finland.

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.

PMID:
8150103
DOI:
10.1016/s0015-0282(16)56638-2
[Indexed for MEDLINE]

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