Document Detail


The hCG ratio can predict the ultimate viability of the intrauterine pregnancies of uncertain viability in the pregnancy of unknown location population.
MedLine Citation:
PMID:  18544580     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: To determine whether hCG ratio at 48 h can predict ultimate viability of intrauterine pregnancies of uncertain viability (IPUVs) in the pregnancy of unknown location (PUL) population. METHODS: Prospective observational study from June 2001 to October 2004. All women classified with PUL had serum hCG levels measured at 0 and 48 h to calculate hCG ratio (hCG 48/hCG 0 h). All women were followed up until final diagnosis: failing PUL, viable and non-viable intrauterine pregnancy (IUP), ectopic pregnancy. Those PULs found to have an IPUV at follow-up transvaginal ultrasound scan (TVS) were included in final analysis. RESULTS: During the study period, 12,572 consecutive first trimester women were scanned. One thousand and three (8%) women were classified PULs. Three hundred and seventy-nine (37.8%) PULs were confirmed IPUVs at follow-up scan. Complete data from 334 IPUVs were analyzed: 82.6% (276/334) viable IUPs and 17.4% (58/334) non-viable IUPs. Median hCG ratio was greater in viable IUPs [2.32, inter-quartile range (IQR) 1.16-4.77] compared with non-viable IUPs 1.83 (IQR 0.97-4.60). Sensitivity, specificity, positive and negative predictive value, positive and negative likelihood ratios of an hCG ratio >2.00 for the prediction of a viable IUP are 77.2%, 95.8%, 86.6%, 90.9%, 15.5, 0.24, respectively. In our population, an hCG ratio >2.00 increases the odds for a viable IUP from 0.42 to 6.46 post-test. CONCLUSIONS: The hCG ratio is significantly higher in those IPUVs which become viable IUPs compared with non-viable IUPs. New cut-offs for the hCG ratio need to be evaluated for the prediction of viability in the IPUV group of PULs.
Authors:
Tommaso Bignardi; George Condous; Dalya Alhamdan; Emma Kirk; Ben Van Calster; Sabine Van Huffel; Dirk Timmerman; Tom Bourne
Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2008-06-10
Journal Detail:
Title:  Human reproduction (Oxford, England)     Volume:  23     ISSN:  1460-2350     ISO Abbreviation:  Hum. Reprod.     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-08-19     Completed Date:  2008-11-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8701199     Medline TA:  Hum Reprod     Country:  England    
Other Details:
Languages:  eng     Pagination:  1964-7     Citation Subset:  IM    
Affiliation:
Early Pregnancy and Gynaecological Ultrasound Unit, Department of Obstetrics and Gynaecology, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK. tommaso.bignardi@alice.it
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MeSH Terms
Descriptor/Qualifier:
Chorionic Gonadotropin / blood*
Female
Humans
Pregnancy
Pregnancy Complications / blood*,  diagnosis
Pregnancy Outcome*
Prospective Studies
Sensitivity and Specificity
Chemical
Reg. No./Substance:
0/Chorionic Gonadotropin

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