| Further evidence against the reliability of the human chorionic gonadotropin discriminatory level. | |
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MedLine Citation:
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PMID: 22123998 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: The human chorionic gonadotropin (hCG) discriminatory level-the maternal serum β-hCG level above which a gestational sac should be consistently visible on sonography in a normal pregnancy--has been reported to be 1000 to 2000 mIU/mL for transvaginal sonography. We assessed whether a woman with a β-hCG above 2000 mIU/mL and no intrauterine fluid collection on transvaginal sonography can subsequently be found to have a live intrauterine gestation and, if so, what the prognosis is for the pregnancy. METHODS: We identified all women scanned between January 1, 2000, and December 31, 2010, who met the following criteria: serum β-hCG testing and transvaginal sonography were performed on the same day; β-hCG was positive and sonography showed no intrauterine fluid collection; and a live intrauterine pregnancy was subsequently documented. We tabulated the β-hCG levels in these cases and assessed pregnancy outcome. RESULTS: A total of 202 patients met the inclusion criteria, including 162 (80.2%) who had β-hCG levels below 1000 mIU/mL on the day of the initial scan showing no intrauterine fluid collection, 19 (9.4%) with levels of 1000 to 1499, 12 (5.9%) 1500 to 1999, and 9 (4.5%) above 2000 mIU/mL. There was no significant relationship between initial β-hCG level and either first-trimester outcome or final pregnancy outcome (P > .05, logistic regression analysis and Fisher exact test). The highest β-hCG was 6567 mIU/mL, and the highest value that preceded a liveborn term baby was 4336 mIU/mL. CONCLUSIONS: The hCG discriminatory level should not be used to determine the management of a hemodynamically stable patient with suspected ectopic pregnancy, if sonography demonstrates no findings of intrauterine or ectopic pregnancy. |
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Authors:
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Peter M Doubilet; Carol B Benson |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine Volume: 30 ISSN: 1550-9613 ISO Abbreviation: J Ultrasound Med Publication Date: 2011 Dec |
Date Detail:
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Created Date: 2011-11-29 Completed Date: 2012-04-11 Revised Date: 2012-06-06 |
Medline Journal Info:
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Nlm Unique ID: 8211547 Medline TA: J Ultrasound Med Country: United States |
Other Details:
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Languages: eng Pagination: 1637-42 Citation Subset: IM |
Affiliation:
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Department of Radiology, Brigham and Women's Hospital, Boston, MA 02115, USA. pdoubilet@partners.org |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Boston / epidemiology Chorionic Gonadotropin / blood* Evidence-Based Medicine* Female Humans Male Pregnancy / blood* Reproducibility of Results Sensitivity and Specificity Ultrasonography, Prenatal / methods*, statistics & numerical data* Yolk Sac / ultrasonography* |
| Chemical | |
Reg. No./Substance:
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0/Chorionic Gonadotropin |
| Comments/Corrections | |
Comment In:
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J Ultrasound Med. 2012 May;31(5):817; author reply 817-8
[PMID:
22535735
]
J Ultrasound Med. 2012 May;31(5):816; author reply 817-8 [PMID: 22535733 ] J Ultrasound Med. 2012 May;31(5):816-7; author reply 817-8 [PMID: 22535734 ] |
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