title: Serum Human Chorionic Gonadotropin (β- hCG) Clearance Curves in Women with Successfully Expectantly Managed Tubal Ectopic Pregnancies: A Retrospective Cohort Study.
abstract: OBJECTIVE
  To establish clearance curves for serum β -hCG in women with successfully expectantly managed tubal ectopic pregnancies.
  
  
  METHODS
  Retrospective cohort study. Non- viable tubal ectopic pregnancy was diagnosed on transvaginal ultrasound. If initial serum β hCG was less than 5000 IU/L and patients were asymptomatic, expectant management was offered. Patients underwent serial β hCG measurements until serum β hCG was less than 20 IU/l, or the urine pregnancy test was negative.
  
  
  METHODS
  Early Pregnancy and Gynaecology Assessment Unit, Kings College Hospital, London (December 1998 to July 2006).
  
  
  METHODS
  We included 161 women with diagnosed non-viable tubal ectopic pregnancy who underwent successful expectant management.
  
  
  METHODS
  Serum β hCG level.
  
  
  RESULTS
  Mean initial serum β- hCG was 488 IU/L (41 - 4883) and median serum β hCG clearance time was 19 days (5 - 82). The average half-life of β hCG clearance was 82.5 hours (±SD 50.2) in patients with steadily declining serum β- hCG levels compared to 106.7 hours (±SD 72.0) in patients with primarily plateauing β-hCG levels in the declining phase. However, these differences were not significant (p>0.05).
  
  
  CONCLUSIONS
  We identified a median follow-up of 19 days until serum β hCG clearance in women with tubal ectopic pregnancy and successful expectant management. Although non- significant, women with initially plateauing serum β hCG showed a longer follow-up time until clearance compared to women with steadily declining β hCG levels. This information may serve as a guideline enabling clinicians to predict the length of follow-up for women with tubal ectopic pregnancy and expectant management.
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria; Early Pregnancy and Gynaecology Assessment Unit, King's College Hospital, London, United Kingdom.
authors.forename: Samir
authors.initials: S
authors.lastname: Helmy
authors.affiliation: Early Pregnancy and Gynaecology Assessment Unit, King's College Hospital, London, United Kingdom.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Mavrelos
authors.affiliation: Early Pregnancy and Gynaecology Assessment Unit, King's College Hospital, London, United Kingdom.
authors.forename: Elinor
authors.initials: E
authors.lastname: Sawyer
authors.affiliation: Early Pregnancy and Gynaecology Assessment Unit, King's College Hospital, London, United Kingdom.
authors.forename: Jara
authors.initials: J
authors.lastname: Ben-Nagi
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria; Karl Landsteiner Society, Vienna, Austria.
authors.forename: Marianne
authors.initials: M
authors.lastname: Koch
authors.affiliation: Gynaecology Diagnostic and Outpatient Treatment Unit, University College Hospitals London (UCL), London, United Kingdom.
authors.forename: Andrea
authors.initials: A
authors.lastname: Day
authors.affiliation: Gynaecology Diagnostic and Outpatient Treatment Unit, University College Hospitals London (UCL), London, United Kingdom.
authors.forename: Davor
authors.initials: D
authors.lastname: Jurkovic
mesh_terms: D000022:Abortion, Spontaneous / Q000097:blood* / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D005260:Female; D006207:Half-Life; D006801:Humans; D011247:Pregnancy; D011274:Pregnancy, Tubal / Q000097:blood* / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D012189:Retrospective Studies; D014463:Ultrasonography
chemical_list: D015415:Biomarkers; D018997:Chorionic Gonadotropin, beta Subunit, Human