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- W2897043831 abstract "Measurements of serum hormones are used to indicate the likely location and viability of a pregnancy when it cannot be visualised with ultrasound and in some cases decide on Methotrexate treatment. We aimed to define the performance of single measurements of serum hCG, progesterone and the hCG ratio (hCG 48hrs/hCG 0hrs) for diagnosing pregnancy viability and location. This was a prospective multi-centre cohort study of 3272 women with a PUL. Eight patients met exclusion criteria, 367 had initial hCG ≤25 IU/L and 297 were lost to follow-up, leaving 2600 for analysis. Serum hCG and progesterone were measured at presentation and hCG again at 48 hours. The final outcome of the pregnancy was classified into three groups: (1) viable IUP (VIUP), (2) non-viable IUP (NVIUP) or failed PUL and (3) ectopic pregnancy (EP) or persisting PUL. We defined the probability of each category across a range of values for single hCG, single progesterone and hCG ratio likely to be encountered in clinical practice and tested their performance in predicting viability and pregnancy location. All analyses were based on available data. We found 19.6% VIUP when single hCG >1000 IU/L, 14.4% when single hCG >2000 IU/L and 11.4% when single hCG >3000 IU/L. No single hCG cut-off excludes an EP. We observed 1.4% VIUP when hCG ratio <1.5. When single progesterone was <10nmol/l, 7.5% PUL were EP and 0.1% were VIUP. Commonly used cut-off values for hCG ratio and progesterone used to define non-viability (hCG >3000 IU/L, hCG ratio <1.5, progesterone <10 nmol/l) may be associated with a viable intrauterine pregnancy. Similarly, single measurements of hCG used to define the likely presence or absence of an EP or VIUP are not specific and should not be used in clinical practice." @default.
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- W2897043831 date "2018-10-01" @default.
- W2897043831 modified "2023-09-24" @default.
- W2897043831 title "OC19.05: Evaluating cut-off values for progesterone, single hCG and hCG ratio to define pregnancy viability and location in women with a pregnancy of unknown location (PUL)" @default.
- W2897043831 doi "https://doi.org/10.1002/uog.19335" @default.
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