Rupture of ectopic pregnancy with minimally detectable beta-human chorionic gonadotropin levels: a report of 2 cases.
BACKGROUND
Several studies have demonstrated that 25-77% of ectopic pregnancies spontaneously resolve with expectant management. However, expectant management is controversial and should be considered only for patients with small, unruptured gestational sacs, low beta-human chorionic gonadotropin (beta-hCG) levels and absence of symptoms. There is no consensus on how long to follow such patients.


METHODS
Two patients with beta-hCG levels < 10 mIU/mL presented with ruptured ectopic pregnancy and hemoperitoneum.


CONCLUSIONS
While expectant management of a suspected ectopic pregnancy may allow spontaneous resolution of such an ectopic pregnancy, rupture may occur at any time and even with extremely low beta-hCG levels. Patients need to be counseled about the risks of rupture and symptoms, immediate action should be taken if symptoms develop, and serum beta-hCG levels should be followed to zero.
Fu
Joyce
J
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Stanford University IVF Program, 900 Welch Road, Suite 350, Palo Alto, CA 94304, USA.
Henne
Melinda B
MB
Blumstein
Sylvie
S
Lathi
Ruth B
RB
D000328:Adult; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood* / Q000378:metabolism; D005260:Female; D006465:Hemoperitoneum / Q000209:etiology*; D006801:Humans; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000473:pathology*; D012422:Rupture, Spontaneous
D018997:Chorionic Gonadotropin, beta Subunit, Human