title: The apparent late half-life of human chorionic gonadotropin (hCG) after surgical treatment for ectopic pregnancy. A new approach to diagnose persistent trophoblastic activity.
abstract: OBJECTIVE
  The disappearance kinetic of human chorionic gonadotropin (hCG) follows a biexponential decay with a rapid initial fall followed later by a slow disappearance. This kinetic is characterised by two half-lives: an early and a late. The objective of this study was to determine if and which half-life could be used clinically to detect persistent trophoblast after conservative surgery in patients with ectopic pregnancy.
  
  
  METHODS
  Retrospective analysis of patients having undergone salpingostomy by laparoscopy for an ectopic tubal pregnancy between January 1990 and October 1993.
  
  
  METHODS
  Gynaecology Department of an University Hospital.
  
  
  METHODS
  104 women with diagnosed tubal ectopic pregnancy were treated by salpingostomy performed under laparoscopy. In seven cases, persistent trophoblast was diagnosed on the basis of plateauing or increasing peripheral hCG values.
  
  
  RESULTS
  From the individual disappearance curves of hCG we calculated the early half-life (early T0.5, from samples obtained between 0 and 48 h postsurgery) and the late half-life (late T0.5, from samples obtained between 2 and 7 days postsurgery). Late T0.5 but not early T0.5 were significantly (P<0.0001 and P=0.416 respectively) longer in women (n =7) in whom a persistent trophoblast was diagnosed. Early T0.5 was dependant on the preoperative value of hCG, whereas late T0.5 was independent. We propose to use late T0.5 as a parameter to follow ectopic pregnancies after treatment.
authors.affiliation: WHO Collaborating Centre in Human Reproduction, Department of Obstetrics and Gynaecology, University Hospital of Geneva, Switzerland.
authors.forename: P
authors.initials: P
authors.lastname: Mock
authors.forename: D
authors.initials: D
authors.lastname: Chardonnens
authors.forename: P
authors.initials: P
authors.lastname: Stamm
authors.forename: A
authors.initials: A
authors.lastname: Campana
authors.forename: P
authors.initials: P
authors.lastname: Bischof
mesh_terms: D006063:Chorionic Gonadotropin / Q000097:blood*; D005187:Fallopian Tubes / Q000601:surgery; D005260:Female; D006207:Half-Life; D006801:Humans; D010535:Laparoscopy; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014327:Trophoblasts / Q000502:physiology*
chemical_list: D006063:Chorionic Gonadotropin