Postoperative day 1 serum human chorionic gonadotropin level as a predictor of persistent ectopic pregnancy after conservative surgical management.
OBJECTIVE
To determine characteristics predictive of persistent ectopic pregnancy (EP).


METHODS
Retrospective cohort study.


METHODS
Tertiary care, university hospital.


METHODS
All women treated surgically for an EP whose postoperative hCG levels were followed until complete resolution or determination of a persistent EP over a 54-month period.


METHODS
Final outcome defined as successful treatment or persistent EP.


RESULTS
Twenty-six (17.7%) of 147 patients were diagnosed with a persistent EP. An inverse relationship was noted between the percent decrease in hCG at postoperative day 1 and the incidence of persistent EP. A significantly greater percentage of persistent EPs were noted when the postoperative day 1 hCG fell < 50% from the initial preoperative hCG level (relative risk = 3.51 [1.25 to 6.68]). No case of persistent EP was noted if the postoperative day 1 hCG declined by > or = 77%. Surgical time differed significantly (129 minutes versus 101 minutes) between cases treated successfully as compared with cases in which conservative treatment failed. No other preoperative or intraoperative variables were found to be significantly different.


CONCLUSIONS
Although no single postoperative hCG value is predictive of conservative surgical treatment for EP, a day-1 postoperative hCG value may be used as a predictor of persistent EP.
Spandorfer
S D
SD
University of Pennsylvania Medical Center, Philadelphia, USA.
Sawin
S W
SW
Benjamin
I
I
Barnhart
K T
KT
D006063:Chorionic Gonadotropin / Q000097:blood*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D011184:Postoperative Period; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000097:blood / Q000601:surgery*; D012189:Retrospective Studies
D006063:Chorionic Gonadotropin