title: Could serum β-hCG levels and gestational age be the indicative factors for the prediction of the degree of trophoblastic invasion into tubal wall in unruptured ampullary pregnancies?
abstract: OBJECTIVE
  To evaluate the predictive value of gestational age and maternal serum β-hCG concentration for the determination of the depth of trophoblastic invasion into the tubal wall.
  
  
  METHODS
  This is a retrospective trial conducted on women with a diagnosis of ampullary pregnancy (71) who were submitted to salpingectomy. Serum β-hCG measurements were obtained at the initial admission of hospital. Histological investigation was performed by a single well-experienced pathologist who was blind to the clinical and laboratory characteristics of the patients. Ampullary pregnancy was classified histologically according to the depth of trophoblastic infiltration into tubal wall: trophoblast limited to the tubal mucosa (stage I), extended to muscularis layer (stage II) and complete tubal wall infiltration up to serosal layer (stage III).
  
  
  RESULTS
  There was a significant difference in maternal serum β-hCG concentrations regarding the histological stages of trophoblastic invasion. The serum β-hCG concentrations that the best predicted for stage III trophoblastic invasion was 6,475 mIU/ml, with a sensitivity of 100 %, a specificity of 92 %.
  
  
  CONCLUSIONS
  The depth of trophoblastic tissue infiltration into tubal wall is correlated with serum β-hCG levels, but not with gestational age. These findings may explain the reason for conservative management failure of EP in women with high β-hCG concentrations.
authors.affiliation: Department of Obstetrics and Gynecology, Istanbul Education and Research Hospital, Kasap Ilyas Mah. Org Abdurrah Nafiz Gurman Cd, 34098 Fatih, Istanbul, Turkey. dremreturgut@gmail.com
authors.forename: Emre Niyazi
authors.initials: EN
authors.lastname: Turgut
authors.forename: Ebru
authors.initials: E
authors.lastname: Celik
authors.forename: Serdar
authors.initials: S
authors.lastname: Celik
authors.forename: Deniz Cemgil
authors.initials: DC
authors.lastname: Arikan
authors.forename: Huseyin
authors.initials: H
authors.lastname: Altuntas
authors.forename: Cem
authors.initials: C
authors.lastname: Leblebici
authors.forename: Sevim
authors.initials: S
authors.lastname: Purisa
authors.forename: Ramazan
authors.initials: R
authors.lastname: Dansuk
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D005260:Female; D005865:Gestational Age; D006801:Humans; D016015:Logistic Models; D011237:Predictive Value of Tests; D011247:Pregnancy; D011274:Pregnancy, Tubal / Q000097:blood / Q000473:pathology* / Q000601:surgery; D057234:Preoperative Period; D012372:ROC Curve; D012189:Retrospective Studies; D058994:Salpingectomy; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D014327:Trophoblasts / Q000473:pathology*
chemical_list: D015415:Biomarkers; D018997:Chorionic Gonadotropin, beta Subunit, Human