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Serum Human Chorionic Gonadotropin (β- hCG) Clearance Curves in Women with Successfully Expectantly Managed Tubal Ectopic Pregnancies: A Retrospective Cohort Study.

Helmy S, Mavrelos D, Sawyer E, Ben-Nagi J, Koch M, Day A, Jurkovic D - PLoS ONE (2015)

Bottom Line: We included 161 women with diagnosed non-viable tubal ectopic pregnancy who underwent successful expectant management.However, these differences were not significant (p>0.05).This information may serve as a guideline enabling clinicians to predict the length of follow-up for women with tubal ectopic pregnancy and expectant management.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria; Early Pregnancy and Gynaecology Assessment Unit, King's College Hospital, London, United Kingdom.

ABSTRACT

Objective: To establish clearance curves for serum β -hCG in women with successfully expectantly managed tubal ectopic pregnancies.

Design: Retrospective cohort study. Non- viable tubal ectopic pregnancy was diagnosed on transvaginal ultrasound. If initial serum β hCG was less than 5000 IU/L and patients were asymptomatic, expectant management was offered. Patients underwent serial β hCG measurements until serum β hCG was less than 20 IU/l, or the urine pregnancy test was negative.

Setting: Early Pregnancy and Gynaecology Assessment Unit, Kings College Hospital, London (December 1998 to July 2006).

Patients: We included 161 women with diagnosed non-viable tubal ectopic pregnancy who underwent successful expectant management.

Main outcome measure: Serum β hCG level.

Results: Mean initial serum β- hCG was 488 IU/L (41 - 4883) and median serum β hCG clearance time was 19 days (5 - 82). The average half-life of β hCG clearance was 82.5 hours (±SD 50.2) in patients with steadily declining serum β- hCG levels compared to 106.7 hours (±SD 72.0) in patients with primarily plateauing β-hCG levels in the declining phase. However, these differences were not significant (p>0.05).

Conclusion: We identified a median follow-up of 19 days until serum β hCG clearance in women with tubal ectopic pregnancy and successful expectant management. Although non- significant, women with initially plateauing serum β hCG showed a longer follow-up time until clearance compared to women with steadily declining β hCG levels. This information may serve as a guideline enabling clinicians to predict the length of follow-up for women with tubal ectopic pregnancy and expectant management.

No MeSH data available.


Related in: MedlinePlus

Ultrasound image of a right tubal ectopic pregnancy at 6+2 weeks gestation.A gestation sac is seen adjacent to the right ovary.
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pone.0130598.g001: Ultrasound image of a right tubal ectopic pregnancy at 6+2 weeks gestation.A gestation sac is seen adjacent to the right ovary.

Mentions: The ultrasound criteria for the diagnosis of ectopic pregnancy in our unit have been published before [2]. Briefly, the diagnosis of EP was made when a well-defined adnexal mass was seen separate from the uterus and the ovary, which had typical morphological characteristics of a tubal EP (Figs 1 and 2). Morphological features of EPs were classified in three groups: gestational sac containing a live embryo, an empty gestational sac with or without a yolk sac and a solid hyperechoic swelling.


Serum Human Chorionic Gonadotropin (β- hCG) Clearance Curves in Women with Successfully Expectantly Managed Tubal Ectopic Pregnancies: A Retrospective Cohort Study.

Helmy S, Mavrelos D, Sawyer E, Ben-Nagi J, Koch M, Day A, Jurkovic D - PLoS ONE (2015)

Ultrasound image of a right tubal ectopic pregnancy at 6+2 weeks gestation.A gestation sac is seen adjacent to the right ovary.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4489732&req=5

pone.0130598.g001: Ultrasound image of a right tubal ectopic pregnancy at 6+2 weeks gestation.A gestation sac is seen adjacent to the right ovary.
Mentions: The ultrasound criteria for the diagnosis of ectopic pregnancy in our unit have been published before [2]. Briefly, the diagnosis of EP was made when a well-defined adnexal mass was seen separate from the uterus and the ovary, which had typical morphological characteristics of a tubal EP (Figs 1 and 2). Morphological features of EPs were classified in three groups: gestational sac containing a live embryo, an empty gestational sac with or without a yolk sac and a solid hyperechoic swelling.

Bottom Line: We included 161 women with diagnosed non-viable tubal ectopic pregnancy who underwent successful expectant management.However, these differences were not significant (p>0.05).This information may serve as a guideline enabling clinicians to predict the length of follow-up for women with tubal ectopic pregnancy and expectant management.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria; Early Pregnancy and Gynaecology Assessment Unit, King's College Hospital, London, United Kingdom.

ABSTRACT

Objective: To establish clearance curves for serum β -hCG in women with successfully expectantly managed tubal ectopic pregnancies.

Design: Retrospective cohort study. Non- viable tubal ectopic pregnancy was diagnosed on transvaginal ultrasound. If initial serum β hCG was less than 5000 IU/L and patients were asymptomatic, expectant management was offered. Patients underwent serial β hCG measurements until serum β hCG was less than 20 IU/l, or the urine pregnancy test was negative.

Setting: Early Pregnancy and Gynaecology Assessment Unit, Kings College Hospital, London (December 1998 to July 2006).

Patients: We included 161 women with diagnosed non-viable tubal ectopic pregnancy who underwent successful expectant management.

Main outcome measure: Serum β hCG level.

Results: Mean initial serum β- hCG was 488 IU/L (41 - 4883) and median serum β hCG clearance time was 19 days (5 - 82). The average half-life of β hCG clearance was 82.5 hours (±SD 50.2) in patients with steadily declining serum β- hCG levels compared to 106.7 hours (±SD 72.0) in patients with primarily plateauing β-hCG levels in the declining phase. However, these differences were not significant (p>0.05).

Conclusion: We identified a median follow-up of 19 days until serum β hCG clearance in women with tubal ectopic pregnancy and successful expectant management. Although non- significant, women with initially plateauing serum β hCG showed a longer follow-up time until clearance compared to women with steadily declining β hCG levels. This information may serve as a guideline enabling clinicians to predict the length of follow-up for women with tubal ectopic pregnancy and expectant management.

No MeSH data available.


Related in: MedlinePlus