Serum beta-hCG titers do not predict ruptured ectopic pregnancy.
OBJECTIVE
To study the relationship of serum beta-hCG titers in unruptured (U) vs. ruptured (R) tubal ectopic pregnancies.


METHODS
183 consecutive tubal ectopic pregnancies, confirmed by surgery and/or pathology, were classified as unruptured (n=108), or ruptured (n=75). Serum beta-hCG was noted directly before the surgery. Patients treated with methotrexate were excluded. The two groups were compared for patient age, gravidity (G), parity (P), gestational age at rupture, and serum beta-hCG level. Differences were analyzed using the Student's paired t-test.


RESULTS
No significant differences were seen for patient age, G or P between the two groups (U vs. R). Gestational age at rupture was significantly higher (p = 0.01) in the ruptured ectopics (U: mean = 6.9 wks., s.d.= 2.2 wks; R: mean = 7.7 wks, s.d. = 2.5 wks). The range in serum beta-hCG was broad for both groups. For U: range = 15-89,504 I.U./L, mean 10,620 I.U./L, s.d. = 17,521 I.U./L. For R: range = 8-75,071 I.U./L, mean = 11,907 I.U./L, s.d. = 17,320 I.U./L (P > .25-N.S.).


CONCLUSIONS
Serum beta-hCG by itself cannot predict whether a tubal ectopic pregnancy is likely to be ruptured; there is no safe lower limit in hCG titer below which ruptured ectopic is not seen.
Galstyan
Kevin
K
Department of Obstetrics and Gynecology, Mount Sinai Hospital and Medical Center, Chicago, Illinois 60608, USA.
Kurzel
Richard B
RB
D000328:Adult; D001685:Biological Factors / Q000097:blood; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D005260:Female; D006801:Humans; D007087:Illinois; D007124:Immunoenzyme Techniques; D011237:Predictive Value of Tests; D011247:Pregnancy; D011274:Pregnancy, Tubal / Q000097:blood* / Q000145:classification*; D012422:Rupture, Spontaneous / Q000097:blood / Q000175:diagnosis
D001685:Biological Factors; D018997:Chorionic Gonadotropin, beta Subunit, Human