Ectopic pregnancy prediction in women with a pregnancy of unknown location: data beyond 48 h are necessary

Human Reproduction
J ZeeKurt Barnhart

Abstract

Are there improvements in the accuracy of prediction of ectopic pregnancy (EP) in women with early symptomatic pregnancy using human chorionic gonadotrophin (hCG) curves when clinicians consider visits beyond the first 48 h after initial presentation? Two hCG values, measured 48 h (2 days) apart, are often not sufficient to accurately predict the outcome of a woman with a pregnancy of unknown location (PUL), but adding a third visit on Day 4 or 7 significantly improved the prediction for 1 in 15 women. The use of serial hCG values is commonly used to aid in the prediction of the final diagnosis in women with a PUL. Initial outcome predictions based on two hCG values may often be incorrect. This retrospective multicenter cohort study included 646 women with a PUL, recruited over 2 years. Of these women, 146 were ultimately diagnosed with EP. Women presenting to the emergency room with first trimester pain or bleeding, with a PUL, at least 2 hCG values and a definitive final diagnosis from the University of Pennsylvania, University of Miami and University of Southern California, were recruited from 2007 to 2009. Using currently recommended prediction rules, adding a third hCG evaluation on Day 4 after initial presentation signifi...Continue Reading

References

Jul 2, 2004·Obstetrics and Gynecology·Kurt T BarnhartWensheng Guo
Feb 4, 2006·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·E KirkT Bourne
Aug 26, 2006·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·G CondousT Bourne
May 9, 2007·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·G CondousT Bourne
Apr 7, 2009·Best Practice & Research. Clinical Obstetrics & Gynaecology·Emma KirkTom Bourne
Jul 25, 2009·The New England Journal of Medicine·Kurt T Barnhart
Feb 24, 2010·Obstetrics and Gynecology·Karen W HooverCharlotte K Kent
Oct 16, 2010·Fertility and Sterility·Kurt BarnhartDirk Timmerman
Oct 23, 2012·Fertility and Sterility·Kurt T Barnhart
Oct 23, 2012·Fertility and Sterility·Norah M van MelloPetra J Hajenius
Jun 25, 2013·Archives of Gynecology and Obstetrics·Poonam RanaFiroz Anwar

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Citations

Aug 22, 2018·BJOG : an International Journal of Obstetrics and Gynaecology·S BobdiwalaT Bourne
Oct 26, 2016·Journal of Midwifery & Women's Health·Loren Fields, Alison Hathaway
Jun 7, 2018·Gynecologic and Obstetric Investigation·Melissa A ParksDavid L Howard
Aug 24, 2018·Der Pathologe·L-C HornC E Brambs

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