Document Detail


Endometrial thickness and serum beta-hCG as predictors of the effectiveness of oral misoprostol in early pregnancy failure.
MedLine Citation:
PMID:  19038070     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate ultrasonographic measurement of endometrial thickness and serum levels of chorionic gonadotropin (beta-hCG) as predictors of failure to abort completely in patients designated for uterine evacuation using oral misoprostol. METHODS: Women attending an obstetric outpatient clinic who complained of residual vaginal bleeding 15 days or more after taking oral misoprostol for medical induction of abortion for early pregnancy failure were evaluated by transvaginal ultrasound scan and assay of serum beta-hCG. They subsequently underwent dilatation and curettage under general anaesthesia. According to the results of histopathological examination of uterine contents, the study cohort was divided into women with incomplete abortion (19 cases, 19.6%) and cases with complete abortion (78 cases, 80.4%). The results of the ultrasound scan and the assay of serum beta-hCG were correlated with the histopathological results to determine the accuracy of these markers in predicting complete abortion. RESULTS: Baseline characteristics for both groups were similar. The endometrial thickness in the two groups ranged from 11.2 +/- 3.9 mm in the complete abortion group to 14.6 +/- 6.1 mm in the incomplete abortion group, a statistically significant difference (P = 0.003). Serum beta-hCG levels were statistically different in the two groups (complete abortion 73.9 +/- 23.9 IU/L vs. incomplete abortion 109.4 +/- 68.4 IU/L, P < 0.001). Measured endometrial thickness > or = 12 mm predicted incomplete abortion with a sensitivity of 88.5%, a specificity of 73.7%, a positive predictive value (PPV) of 93.2%, and a positive likelihood ratio (LR+ve) of 85.6. A serum beta-hCG > or = 100 IU/L predicted incomplete abortion with a sensitivity of 87.2%, a specificity of 78.9%, a PPV of 94.4%, and a LR+ve of 85.6. CONCLUSION: Quantitative assay of serum beta-hCG and ultrasound measurement of endometrial thickness are clinically useful measures for predicting late failure of medical abortion, but should be used as supplements to clinical assessments.
Authors:
Sahar M Y El-Baradie; Manal H El-Said; Wael S Ragab; Khaled M Elssery; Manal Mahmoud
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstétrique et gynécologie du Canada : JOGC     Volume:  30     ISSN:  1701-2163     ISO Abbreviation:  J Obstet Gynaecol Can     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-11-28     Completed Date:  2009-02-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101126664     Medline TA:  J Obstet Gynaecol Can     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  877-81     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Al Fayom University, Egypt.
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MeSH Terms
Descriptor/Qualifier:
Abortifacient Agents, Nonsteroidal / therapeutic use*
Abortion, Incomplete
Abortion, Induced*
Administration, Oral
Adult
Chorionic Gonadotropin, beta Subunit, Human / blood*
Endometrium / ultrasonography*
Female
Humans
Misoprostol / therapeutic use*
Pregnancy
Prospective Studies
Sensitivity and Specificity
Chemical
Reg. No./Substance:
0/Abortifacient Agents, Nonsteroidal; 0/Chorionic Gonadotropin, beta Subunit, Human; 59122-46-2/Misoprostol

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