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Ectopic pregnancy is the leading cause of first-trimester maternal deaths, yet its diagnosis frequently is elusive in the ED. In 2 new studies, researchers evaluated the role of laboratory markers in diagnosing ectopic pregnancy.
In one study, investigators measured serum progesterone levels by radioimmunoassay in 716 symptomatic (abdominal pain or vaginal bleeding) first-trimester ED patients. Ultimately, 52 patients (7.3 percent) proved to have ectopic pregnancies; 17 ruptured. A derivation analysis in 399 patients indicated that a progesterone cutoff value of less than 22 ng/mL was a testable endpoint for the diagnosis of ectopic pregnancy. In a validation phase, this cutoff value was tested in 317 patients. Overall, the sensitivity, spec…