title: Prediction of residual trophoblastic tissue in first-trimester abortions and low levels of human chorionic gonadotropin beta-subunit.
abstract: The clinical data and the histologic report of curettage specimens of 174 patients with first-trimester abortion and human chorionic gonadotropin beta-subunit less than 500 mIU/ml were reviewed. In only 22 (12.6%) were chorionic villi histologically reported. A multivariate analysis showed that increased log human chorionic gonadotropin beta-subunit levels within the range of 20 to 500 mIU/ml, intrauterine tissue demonstrated by ultrasonography, higher gestational age, and active bleeding were significant predictive variables for the presence of villi in curettage specimens. A mathematical formula and a clinical scoring system for the prediction of residual villi in these cases were devised and were applied to the data of our study group. The sensitivity, false-negative rate, and specificity of the scoring system were 90.9%, 2.2%, and 59.2%, respectively; however, the false-positive rate was 75.6%. By use of this scoring system in patients with first-trimester abortion and low human chorionic gonadotropin beta-subunit level, the presence of villi in curettage specimens can thus be predicted with a high sensitivity and as many as 60% of curettage procedures might be prevented.
authors.affiliation: Department of Obstetrics and Gynecology, Sheba Medical Center, Sackler School of Medicine, Tel Aviv University.
authors.forename: E
authors.initials: E
authors.lastname: Schiff
authors.forename: G
authors.initials: G
authors.lastname: Ben-Baruch
authors.forename: O
authors.initials: O
authors.lastname: Moran
authors.forename: I
authors.initials: I
authors.lastname: Yahal
authors.forename: G
authors.initials: G
authors.lastname: Oelsner
authors.forename: S
authors.initials: S
authors.lastname: Mashiach
authors.forename: J
authors.initials: J
authors.lastname: Menczer
mesh_terms: D000028:Abortion, Induced; D000328:Adult; D006063:Chorionic Gonadotropin / Q000097:blood; D003656:Decidua / Q000473:pathology; D004107:Dilatation and Curettage; D005260:Female; D005544:Forecasting; D006801:Humans; D008871:Microvilli / Q000648:ultrastructure; D012189:Retrospective Studies; D014327:Trophoblasts / Q000648:ultrastructure*; D014599:Uterus / Q000473:pathology
chemical_list: D006063:Chorionic Gonadotropin