title: Slow rising serial chorionic gonadotropins predict poor pregnancy outcome despite sonographic viability.
abstract: OBJECTIVE
  To determine the prognosis of women with slow rising beta-hCG levels when viability is detected by ultrasound.
  
  
  METHODS
  Serum beta-hCG levels were obtained every two to three days in the early first trimester. Doubling-time (DT) of beta-hCG levels was defined as DT exceeding 3.2 days. Sonography was performed at eight weeks and then after 12 weeks.
  
  
  RESULTS
  There were 158 consecutive pregnancies evaluated and 111 (70%) had normal rising beta-hCG levels, viable ultrasound at eight weeks, and viable pregnancies after 12 weeks. There were 22 pregnancies with slow rising beta-hCG levels (13.9%) with 16 (72.7%) showing viability at eight weeks but not after the first trimester. A sac-crown rump length discrepancy with a sac smaller than normal was found in 11 of these 16 (68.7%) women.
  
  
  CONCLUSIONS
  Patients with slow rising beta-hCG levels should not be given an optimistic prognosis even if viability is demonstrated at eight weeks.
authors.affiliation: The University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School at Camden, Cooper Hospital/University Medical Center, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology & Infertility, Camden, NJ, USA.
authors.forename: J H
authors.initials: JH
authors.lastname: Check
authors.forename: J R
authors.initials: JR
authors.lastname: Liss
authors.forename: Y
authors.initials: Y
authors.lastname: Katz
authors.forename: K
authors.initials: K
authors.lastname: Shucoski
mesh_terms: D000328:Adult; D006063:Chorionic Gonadotropin / Q000097:blood* / Q000378:metabolism; D015331:Cohort Studies; D018568:Crown-Rump Length; D005260:Female; D047109:Fetal Development / Q000502:physiology*; D005323:Fetal Monitoring; D006340:Heart Rate, Fetal; D006801:Humans; D008991:Monitoring, Physiologic; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First; D011295:Prenatal Care / Q000379:methods; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal
chemical_list: D006063:Chorionic Gonadotropin