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Use of a Radioimmunoassay Specific for Human Chorionic Gonadotropin in the Diagnosis of Early Ectopic Pregnancy

From the Department of Surgery (GYN) at Peter Bent Brigham Hospital and the Harvard Medical School, Boston, Massachusetts.

The development of a highly sensitive radio-immunoassay with a specific affinity for the beta subunit of human chorionic gonadotropin (HCG) has made it possible to detect chorionic activity only a few days after implantation. Using this radioimmunoassay, positive serum levels of HCG were measured in 4 patients with abdominal pain and a history of a missed period. The pregnancy test was negative in all 4 cases. Due to the very low levels of HCG in those patients relative to their last menstrual periods, an ectopic or abnormal gestation was suspected and they were admitted for laparoscopy, and a unilateral tubal ectopic pregnancy was found in each case. The possibility of distinguishing an early ectopic or abnormally developing gestation from a normal intrauterine pregnancy may be a possibility with this assay, although a larger series would have to be studied in order to make any definite conclusions.