Human chorionic gonadotropin ratio of hemoperitoneum versus venous serum improves early diagnosis of ectopic pregnancy
Received 15 July 2008; received in revised form 7 October 2008; accepted 11 October 2008. published online 01 December 2008.
Objective
To analyze the value of the hCG ratio of peritoneal serum versus venous serum (RP/V) for early diagnosis and prognostic evaluation of ectopic pregnancy (EP).
Design
Retrospective clinical study.
Setting
University hospital.
Patient(s)
One hundred three women with hemoperitoneum and positive urine hCG tests underwent laparoscopy or laparotomy.
Intervention(s)
Venous serum and peritoneal serum samples were obtained; ultrasound was performed in all the patients; dilatation and curettage was used in 28 patients.
Main Outcome Measure(s)
Quantitative hCG and RP/V.
Result(s)
The RP/V in EP (5.55 ± 4.32) is apparently greater than that in hemoperitoneum with intrauterine pregnancy (hIUP; 0.61 ± 0.18). The median RP/V is 4.07 in the EP group versus 0.60 in the hIUP group, with a suggested threshold value of 1.0 for their differential diagnosis. Moreover, the RP/V of EP shows the dominant difference between the patients with active bleeding (8.03 ± 3.29, n = 24) and the patients without active bleeding (4.59 ± 3.88, n = 16) when the hCG level of venous serum is more than 1500 U/L.
Conclusion(s)
RP/V could instantly diagnose ectopic pregnancy and differentiate it from hIUP.
aDepartment of Obstetrics and Gynecology, the Sixth People's Hospital, Shanghai Jiaotong University, Shanghai, People's Republic of China
bDepartment of Radiology and Pathology, the Methodist Hospital, Weill Medical College, Cornell University, Houston, Texas
Reprint requests: YinCheng Teng, Department of Obstetrics and Gynecology, the Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 200233, People's Republic of China (FAX: 0086-021-64701361).
The first two authors contributed equally to this work.
Y.D.W. has nothing to disclose. H.Z. has nothing to disclose. Y.C.T. has nothing to disclose. L.H.L. has nothing to disclose. J.Q.T. has nothing to disclose.
This study was supported by the Foundation of the Sixth People's Hospital, Shanghai Jiaotong University, China, grant no. 0875 (to Y.D.W.).
ABSTRACT