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Ectopic Pregnancy

Changes in Serum Human Chorionic Gonadotropin Concentration

From the Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville; Tennessee.

Abstract

In 93 patients with surgically proved ectopic gestation, the initial serum ß-human chorionic gonadotropin (hCG) concentration ranged from 2.0 to 5260 ng/ml; in 33 (35%) the values were below 100 ng/ml. Of 25 patients with serial hCG data, 20 showed a plateau or fall in serum concentrations over at least 48 hours, thereby identifying the gestation as nonviable. Sixty-four patients underwent sonographic evaluation; 35 of these also underwent at least one quantitated hCG determination. Correlating a single hCG value with the sonographic diagnosis correctly identified the gestation as nonviable in 21% of the cases, but a definite diagnosis was not possible in the rest. For the clinically stable patient with a suspected ectopic pregnancy, serial hCG determinations offer a useful technique for evaluating gestational viability.

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				A.H. De Cherney and J.H. Eichhorn Case 3-1996- Severe Abdominal Pain during Early Pregnancy in a Woman with Previous Infertility N. Engl. J. Med., January 25, 1996; 334(4): 255 - 260. [Full Text] [PDF]