Publication:

How important is serum β-hCG in the management of ectopic pregnancy?

Background Objective: To investigate whether serum β-hCG levels may influence presentation & management of ectopic pregnancy.

Methods A total of 176 women diagnosed with ectopic pregnancy were divided into 4 groups based on initial serum β-hCG values; group 1 - 5000 mIU/ml. The clinical presentations, ultrasound findings, mode of management & success of medical management in relation to serum β-hCG values were recorded.

Results There were no significant correlations between Serum β-hCG values and ultrasound findings. Ectopic pregnancies with values less than 1000 mIU/ml could also present with rupture, requiring surgical management. A falling trend on Day 4 serum β-hCG was a good predictor of successful medical management. Out of the 28 patients managed medically, 21 (75%) had resolution of ectopic pregnancy, remaining 7, who did not show a subsequent decline on the fourth day, required either repeat dosage or surgical intervention. The study also revealed a positive correlation between initial β-hCG values and site of ectopic gestation. More than 80% (16/19) of patients with cornual ectopic had initial values greater than 10,000 mIU/ml.

Conclusions Serum β-hCG is a complementary and a useful tool in diagnosis & management of ectopic pregnancy.