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• W2599235549 abstract "Objective To evaluate the percentage change in total βeta‐unit human chorionic gonadotropin (βhCG) levels (%Δβh CG ) in the prediction of treatment outcomes following intravaginal misoprostol for missed miscarriage before 13 weeks. Methods A secondary analysis of a randomised controlled study of medical management of miscarriage was performed. Total βh CG levels were collected before misoprostol (baseline) and after a planned seven day interval (follow‐up), when a transvaginal ultrasound ( TVUS ) reported a gestational sac as present or not. If no sac at TVUS , surgery was indicated on clinical criteria. %Δβh CG ((baseline βh CG – follow‐up βh CG )/baseline βh CG × 100) was evaluated in the prediction of a sac at TVUS and surgery on clinical criteria. Results %Δβh CG was calculated for cases with βh CG levels within two days of misoprostol and TVUS ; calculation interval determined case number. The median %Δβh CG for 24 cases with a persistent sac (6–9 day interval) was significantly lower than for 145 with no sac (58.75% (interquartile range (IQR): 37.59–76.69; maximum 86.54) vs 97.65% ( IQR : 95.44–98.43); P < 0.0001). The median %Δβh CG for eight cases needing surgery on clinical criteria (5–9 day interval) was significantly lower than for 140 cases with no sac not needing surgery (79.68% ( IQR : 64.63–91.15; maximum 94.06) vs 97.68% ( IQR : 95.61–98.50); P < 0.0001). The area under the receiver‐operator curve was 0.975 for prediction of a persistent sac and 0.944 for prediction of surgery on clinical criteria, respectively. %Δβh CG > 87% predicted no sac at TVUS . %Δβh CG > 94.5% predicted no surgery on clinical criteria. Conclusion %Δβh CG calculation over one week reliably predicted treatment outcomes after medical management of missed miscarriage." @default.
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• W2599235549 date "2017-03-27" @default.
• W2599235549 modified "2023-09-27" @default.
• W2599235549 title "Utility of βhCG monitoring in the follow-up of medical management of miscarriage" @default.
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• W2599235549 doi "https://doi.org/10.1111/ajo.12607" @default.
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