Peisner D B, Timor-Tritsch I E
Department of Obstetrics and Gynecology, Columbia Presbyterian Medical Center, New York, New York 10032.
J Clin Ultrasound. 1990 May;18(4):280-5. doi: 10.1002/jcu.1870180411.
Recent developments in both laboratory measurements and ultrasound technology have revolutionized the management of early pregnancy. The discriminatory zone concept is a direct result of these developments. By correlating the serum beta-hCG values to the size of an intrauterine gestational sac, a value can be chosen that corresponds to the threshold of visualization of the sac. If the beta-hCG is above this value, a sac must be seen, and if it is not, aggressive steps should be taken to determine whether the pregnancy is abnormal or ectopic. The discriminatory zone may vary among institutions due to different equipment and assays. Thus, its value should be calculated individually at each institution. A proper discriminatory zone and a management protocol such as the one above can eliminate much of the uncertainty in the management of suspected ectopic and early pregnancies.
实验室检测和超声技术的最新进展彻底改变了早期妊娠的管理方式。鉴别值概念就是这些进展的直接成果。通过将血清β-人绒毛膜促性腺激素（β-hCG）值与宫内妊娠囊大小相关联，可以选择一个与妊娠囊可视化阈值相对应的值。如果β-hCG高于此值，则必须看到妊娠囊，反之则应采取积极措施以确定妊娠是否异常或为异位妊娠。由于设备和检测方法不同，各机构的鉴别值可能会有所差异。因此，每个机构都应单独计算其鉴别值。一个合适的鉴别值以及诸如上述的管理方案，可以消除疑似异位妊娠和早期妊娠管理中的许多不确定性。
