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Serum β‐human chorionic gonadotropin profile and its correlations with ultrasound parameters in low‐lying‐implantation ectopic pregnancy in the first trimester
Author(s) -
Tsai NiChin,
Cheng LingYun,
Yang TsaiHwa,
Hsu TeYao,
Kung FuTsai
Publication year - 2020
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.14248
Subject(s) - medicine , human chorionic gonadotropin , ectopic pregnancy , pregnancy , gestational sac , obstetrics , gestational age , ultrasound , gynecology , gonadotropin , clinical significance , hormone , endocrinology , radiology , biology , genetics
Aim Cervical pregnancy (CP) and cesarean scar pregnancy (CSP), defined as low‐lying‐implantation ectopic pregnancy (LLIEP), are rare conditions of aberrant implantation around the lowest portion of the uterus. This study aimed to illustrate the serum β‐human chorionic gonadotropin (β‐hCG) profile of LLIEP and to explore its implications with the clinical characteristics. Methods Women with LLIEP during the first trimester were retrospectively evaluated at a tertiary referral center from August 1999 to July 2016. Demographic and clinical data were recorded, including maternal age, gestational age (GA), serum β‐hCG level, maximal diameter of the gestational mass/sac (MDM/MDS) by ultrasonography and CSP implantation types. The serum β‐hCG level was measured on the day of ultrasound imaging. The significance of pretreatment the serum β‐hCG level and its correlations with the clinical characteristics were analyzed. Results A total of 88 LLIEP with 64 CSP and 24 CP was included. The mean GA at the time of diagnosis was 7 weeks (range, 5–12 weeks). The β‐hCG concentrations rapidly increased from GA 5 to 9 weeks and fluctuated thereafter. The β‐hCG levels correlated positively with GA and ultrasound MDM/MDS. In the CSP group, there was no difference in the β‐hCG level between superficial and deep implantation types. β‐hCG levels demonstrated no significant differences among simple and complicated LLIEP. Conclusion This study established the serum β‐hCG profile in LLIEP in the first trimester. The exponential increase of β‐hCG levels was similar to that of normal intrauterine pregnancies. The β‐hCG levels were not associated with placentation complexity of CSP. Higher β‐hCG levels did not implicate less success in conservative surgical management.