The Role of Serum Beta hcg in Early Diagnosis and Management Strategy of Ectopic Pregnancy
Introduction: The presentation of Ectopic Pregnancy (EP) can be highly variable and serum Beta hCG estimation plays an important role in early diagnosis. Aim: Aim of the study was to determine the trends of hCG levels in EP and to explore the role of hCG in decisions related to management and f...
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doaj-f4a84aafaad843d5b03911c492bb4ccf2020-11-25T03:06:13ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2016-07-01107QC08QC1010.7860/JCDR/2016/19342.8110The Role of Serum Beta hcg in Early Diagnosis and Management Strategy of Ectopic PregnancyKameswari Surampudi0Sirisha Rao Gundabattula1Head of the Department, Department of Gynaecology, Fernandez Hospital, Hyderabad, India.Consultant, Department of Gynaecology, Fernandez Hospital, Hyderabad, India.Introduction: The presentation of Ectopic Pregnancy (EP) can be highly variable and serum Beta hCG estimation plays an important role in early diagnosis. Aim: Aim of the study was to determine the trends of hCG levels in EP and to explore the role of hCG in decisions related to management and follow-up of EPs. Materials and Methods: A retrospective study of women who had EPs from January 2006 to December 2012 at an advanced tertiary care centre in southern India was carried out. These women had undergone treatment based on the hospital protocol. Results: The study identified 337 women with EP. Thirty one surgically confirmed cases were diagnosed below the discriminatory zone of 1500 mIU/ml. Among women who had Beta hCG estimations 48 hours apart, plateauing was observed in 22.5% while decrease >15% was noted in 26.8%. Almost half (47.9%) of the cases had an increase >15% and a few (2.8%) demonstrated an initial fall followed by a rise in titres. In 23.9% of these women, there was a rise >53% similar to intrauterine pregnancy. The average pre-treatment Beta hCG was 429.8, 3866.2 and 12961.5 mIU/ml for those who received expectant, medical and direct surgical treatment respectively. 43 women with relative contraindications received medical management and 39 were lost to follow-up after medical and expectant management. Excluding them, the success rate of these two modalities was 76.6% and 85.0% respectively. Conclusion: No single level of Beta hCG is diagnostic of EP and serial levels can demonstrate atypical trends in some cases. Hence, interpretation of these results should be done in conjunction with clinical and sonographic findings to arrive at a correct diagnosis.https://jcdr.net/articles/PDF/8110/19342_CE(RA1)_F(T)_PF1(ROAK)_PFA(AK)_PF2(PAG).pdfbeta human chorionic gonadotropinhcg assaystransvaginal ultrasonography |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Kameswari Surampudi Sirisha Rao Gundabattula |
spellingShingle |
Kameswari Surampudi Sirisha Rao Gundabattula The Role of Serum Beta hcg in Early Diagnosis and Management Strategy of Ectopic Pregnancy Journal of Clinical and Diagnostic Research beta human chorionic gonadotropin hcg assays transvaginal ultrasonography |
author_facet |
Kameswari Surampudi Sirisha Rao Gundabattula |
author_sort |
Kameswari Surampudi |
title |
The Role of Serum Beta hcg in Early Diagnosis and Management Strategy of Ectopic Pregnancy |
title_short |
The Role of Serum Beta hcg in Early Diagnosis and Management Strategy of Ectopic Pregnancy |
title_full |
The Role of Serum Beta hcg in Early Diagnosis and Management Strategy of Ectopic Pregnancy |
title_fullStr |
The Role of Serum Beta hcg in Early Diagnosis and Management Strategy of Ectopic Pregnancy |
title_full_unstemmed |
The Role of Serum Beta hcg in Early Diagnosis and Management Strategy of Ectopic Pregnancy |
title_sort |
role of serum beta hcg in early diagnosis and management strategy of ectopic pregnancy |
publisher |
JCDR Research and Publications Private Limited |
series |
Journal of Clinical and Diagnostic Research |
issn |
2249-782X 0973-709X |
publishDate |
2016-07-01 |
description |
Introduction: The presentation of Ectopic Pregnancy (EP) can
be highly variable and serum Beta hCG estimation plays an
important role in early diagnosis.
Aim: Aim of the study was to determine the trends of hCG levels
in EP and to explore the role of hCG in decisions related to
management and follow-up of EPs.
Materials and Methods: A retrospective study of women
who had EPs from January 2006 to December 2012 at an
advanced tertiary care centre in southern India was carried out.
These women had undergone treatment based on the hospital
protocol.
Results: The study identified 337 women with EP. Thirty
one surgically confirmed cases were diagnosed below the
discriminatory zone of 1500 mIU/ml. Among women who had
Beta hCG estimations 48 hours apart, plateauing was observed
in 22.5% while decrease >15% was noted in 26.8%. Almost half
(47.9%) of the cases had an increase >15% and a few (2.8%)
demonstrated an initial fall followed by a rise in titres. In 23.9%
of these women, there was a rise >53% similar to intrauterine
pregnancy. The average pre-treatment Beta hCG was 429.8,
3866.2 and 12961.5 mIU/ml for those who received expectant,
medical and direct surgical treatment respectively. 43 women
with relative contraindications received medical management
and 39 were lost to follow-up after medical and expectant
management. Excluding them, the success rate of these two
modalities was 76.6% and 85.0% respectively.
Conclusion: No single level of Beta hCG is diagnostic of EP
and serial levels can demonstrate atypical trends in some
cases. Hence, interpretation of these results should be done in
conjunction with clinical and sonographic findings to arrive at a
correct diagnosis. |
topic |
beta human chorionic gonadotropin hcg assays transvaginal ultrasonography |
url |
https://jcdr.net/articles/PDF/8110/19342_CE(RA1)_F(T)_PF1(ROAK)_PFA(AK)_PF2(PAG).pdf |
work_keys_str_mv |
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