How Best to Predict Ectopic Pregnancy

Clinical judgment plus serial human chorionic gonadotropin measurements are critical for avoiding errors of diagnosis.

To diagnose ectopic pregnancy (EP), clinicians typically rely on interpretation of serial values of human chorionic gonadotropin (hCG) along with transvaginal ultrasound and clinical history (JW Emerg Med Dec 16 2011). Now, researchers have evaluated the accuracy of serial hCG measurements in predicting outcomes in 1005 women who presented at three U.S. sites with first-trimester pain or bleeding suggestive of pregnancies of unknown location.

Patients were followed until they were diagnosed with EP (179 pregnancies), miscarriage (567), or intrauterine pregnancy (IUP; 259). Misclassification of an IUP was best avoided by using 35% as the minimum expected hCG increase over 2 days. That same cutoff, when applied in combination with a minimum ex…

Reviewing Author

Robert W. Rebar, MD

Disclosures

Consultant/Advisory BoardMyovant Sciences, Inc.

Editorial BoardsEndoText; Clinical OB/GYN Alert

Leadership Positions in Professional SocietiesAmerican Society for Reproductive Medicine (Member, Ethics Committee)

Robert W. Rebar, MD

Disclosures

Consultant/Advisory BoardMyovant Sciences, Inc.

Editorial BoardsEndoText; Clinical OB/GYN Alert

Leadership Positions in Professional SocietiesAmerican Society for Reproductive Medicine (Member, Ethics Committee)

How Best to Predict Ectopic Pregnancy

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Reviewing Author