PMID- 18544580
OWN - NLM
STAT- MEDLINE
DCOM- 20081117
LR  - 20191210
IS  - 1460-2350 (Electronic)
IS  - 0268-1161 (Linking)
VI  - 23
IP  - 9
DP  - 2008 Sep
TI  - The hCG ratio can predict the ultimate viability of the intrauterine pregnancies 
      of uncertain viability in the pregnancy of unknown location population.
PG  - 1964-7
LID - 10.1093/humrep/den221 [doi]
AB  - BACKGROUND: To determine whether hCG ratio at 48 h can predict ultimate viability 
      of intrauterine pregnancies of uncertain viability (IPUVs) in the pregnancy of 
      unknown location (PUL) population. METHODS: Prospective observational study from 
      June 2001 to October 2004. All women classified with PUL had serum hCG levels 
      measured at 0 and 48 h to calculate hCG ratio (hCG 48/hCG 0 h). All women were 
      followed up until final diagnosis: failing PUL, viable and non-viable 
      intrauterine pregnancy (IUP), ectopic pregnancy. Those PULs found to have an IPUV 
      at follow-up transvaginal ultrasound scan (TVS) were included in final analysis. 
      RESULTS: During the study period, 12,572 consecutive first trimester women were 
      scanned. One thousand and three (8%) women were classified PULs. Three hundred 
      and seventy-nine (37.8%) PULs were confirmed IPUVs at follow-up scan. Complete 
      data from 334 IPUVs were analyzed: 82.6% (276/334) viable IUPs and 17.4% (58/334) 
      non-viable IUPs. Median hCG ratio was greater in viable IUPs [2.32, 
      inter-quartile range (IQR) 1.16-4.77] compared with non-viable IUPs 1.83 (IQR 
      0.97-4.60). Sensitivity, specificity, positive and negative predictive value, 
      positive and negative likelihood ratios of an hCG ratio >2.00 for the prediction 
      of a viable IUP are 77.2%, 95.8%, 86.6%, 90.9%, 15.5, 0.24, respectively. In our 
      population, an hCG ratio >2.00 increases the odds for a viable IUP from 0.42 to 
      6.46 post-test. CONCLUSIONS: The hCG ratio is significantly higher in those IPUVs 
      which become viable IUPs compared with non-viable IUPs. New cut-offs for the hCG 
      ratio need to be evaluated for the prediction of viability in the IPUV group of 
      PULs.
FAU - Bignardi, Tommaso
AU  - Bignardi T
AD  - Early Pregnancy and Gynaecological Ultrasound Unit, Department of Obstetrics and 
      Gynaecology, St George's, University of London, Cranmer Terrace, London SW17 0RE, 
      UK. tommaso.bignardi@alice.it
FAU - Condous, George
AU  - Condous G
FAU - Alhamdan, Dalya
AU  - Alhamdan D
FAU - Kirk, Emma
AU  - Kirk E
FAU - Van Calster, Ben
AU  - Van Calster B
FAU - Van Huffel, Sabine
AU  - Van Huffel S
FAU - Timmerman, Dirk
AU  - Timmerman D
FAU - Bourne, Tom
AU  - Bourne T
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
DEP - 20080610
PL  - England
TA  - Hum Reprod
JT  - Human reproduction (Oxford, England)
JID - 8701199
RN  - 0 (Chorionic Gonadotropin)
SB  - IM
MH  - Chorionic Gonadotropin/*blood
MH  - Female
MH  - Humans
MH  - Pregnancy
MH  - Pregnancy Complications/*blood/diagnosis
MH  - *Pregnancy Outcome
MH  - Prospective Studies
MH  - Sensitivity and Specificity
EDAT- 2008/06/12 09:00
MHDA- 2008/11/18 09:00
CRDT- 2008/06/12 09:00
PHST- 2008/06/12 09:00 [pubmed]
PHST- 2008/11/18 09:00 [medline]
PHST- 2008/06/12 09:00 [entrez]
AID - den221 [pii]
AID - 10.1093/humrep/den221 [doi]
PST - ppublish
SO  - Hum Reprod. 2008 Sep;23(9):1964-7. doi: 10.1093/humrep/den221. Epub 2008 Jun 10.