title: Low beta-hCG is associated with poor prognosis in association with an embryo with positive cardiac activity.
abstract: Seven pregnancies with positive fetal heart activity and low or very low serum beta-human chorionic gonadotropin (beta-hCG) levels were investigated. The gestational age by dates was between 6 weeks 3 days and 8 weeks 4 days at the time of the first ultrasound scan and beta-hCG ranged between 282 and 10,000 mIU/ml of the Second International Standard. The crown-rump lengths ranged between 6 and 13 mm and heart activity was always detected. Four cases were scanned because beta-hCG was lower than that expected for the gestational age; in these cases the yolk sac was present but the gestational sacs were small, with a trophoblastic ring that looked thin and subjectively seemed abnormal. The beta-hCG level was measured in the other three cases, because the gestational sacs were small and had a thin trophoblastic ring. In these cases, fetal heart activity was clearly imaged. All cases were scheduled for a repeat ultrasound scan 2 weeks later. Three cases aborted spontaneously the following week, whereas in the other four no heart activity was detected in a repeat sonogram 2 weeks later. Low serum beta-hCG levels indicate a poor prognosis even when associated with an embryo with positive cardiac activity detected ultrasonographically.
authors.affiliation: Laiko General Hospital, Athens, Greece.
authors.forename: C N
authors.initials: CN
authors.lastname: Christodoulou
authors.forename: C
authors.initials: C
authors.lastname: Zonas
authors.forename: T
authors.initials: T
authors.lastname: Loukaides
authors.forename: A
authors.initials: A
authors.lastname: Maniatis
authors.forename: L
authors.initials: L
authors.lastname: Giannikos
authors.forename: C
authors.initials: C
authors.lastname: Giannakopoulos
authors.forename: M
authors.initials: M
authors.lastname: Fassoula
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology*; D006063:Chorionic Gonadotropin / Q000097:blood*; D018997:Chorionic Gonadotropin, beta Subunit, Human; D005314:Embryonic and Fetal Development; D005260:Female; D005318:Fetal Heart / Q000000981:diagnostic imaging*; D006801:Humans; D010446:Peptide Fragments / Q000097:blood*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First; D011379:Prognosis; D011863:Radioimmunoassay; D016216:Ultrasonography, Prenatal
chemical_list: D006063:Chorionic Gonadotropin; D018997:Chorionic Gonadotropin, beta Subunit, Human; D010446:Peptide Fragments