title: Human Chorionic Gonadotropine in Cul-de-sac Fluid in Tubal Ectopic Pregnacy; A New Diagnostic Approach.
abstract: BACKGROUND
  Although new diagnostic abilities are being utilised increasingly yet early detection of tubal pregnancy remains a challenge. The use of highly sensitive hCG kits has facilitated the early diagnosis of a pregnancy. But it takes time to determine the localisation of the pregnancy. Early diagnosis of ectopic pregnancy may reduce the morbidity of ectopic pregnancy.
  
  
  OBJECTIVE
  This study was conducted to analyse the cul-de-sac and serum βhCG ratio in tubal ectopic pregnancy cases which may be a new diagnostic approach for ectopic pregnancy.
  
  
  METHODS
  Between January 2004 and July 2011, 263 patients with ectopic pregnancy were included in the study. Risk factors of patients and treatment modalities were evaluated. hCG was measured in peripheral serum and peritoneal fluid, obtained by puncture of Douglas pouch in 52 patients with tubal ectopic pregnancy. hCG level was determined in the cul-de-sac fluid and in the maternal serum for comparison.
  
  
  RESULTS
  Tubectomy (5.3%), history of abortion (9.5%), history of previous surgery (14.8%), previous cesarean section (8%) and pelvic infamatorry disease (15.9 %) were the important risk factors for ectopic pregnancy in our cases. In 51 of 52 patients with tubal pregnancy, the cul-de-sac hCG vaule and the serum hCG value ratio was >1.
  
  
  CONCLUSIONS
  It is concluded that the ratio of hCG in cul-de -sac and serum can be used for the verification of tubal ectopic pregnancy in addition to other diagnostic methods. This may help rapid confirmation of the diagnosis of ectopic pregnancy.
authors.affiliation: Faculty, Department of Obstetrics and Gynecology, Süleymaniye Maternity Hospital , Bakirkoy, Istanbul .
authors.forename: Ayse
authors.initials: A
authors.lastname: Karahasanoglu
authors.affiliation: Faculty, Department of Obstetrics and Gynecology, Acibadem Bakirkoy Hospital , Bakirkoy, Istanbul .
authors.forename: Isil
authors.initials: I
authors.lastname: Uzun
authors.affiliation: Faculty, Department of Obstetrics and Gynecology, Süleymaniye Maternity Hospital , Bakirkoy, Istanbul .
authors.forename: Mucize
authors.initials: M
authors.lastname: Ozdemir
authors.affiliation: Faculty, Department of Obstetrics and Gynecology, Süleymaniye Maternity Hospital , Bakirkoy, Istanbul .
authors.forename: Fehmi
authors.initials: F
authors.lastname: Yazicioglu
keywords: Diagnostic; Douglas hCG; Puncture