Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
Fertil Steril. 2012 Oct;98(4):911-6. doi: 10.1016/j.fertnstert.2012.06.026. Epub 2012 Jul 12.
To investigate the hCG profiles in a diverse patient group with ectopic pregnancy (EP) and to understand when they may mimic the curves of an intrauterine pregnancy (IUP) or spontaneous abortion (SAB).
Retrospective cohort study.
Three university hospitals.
PATIENT(S): One hundred seventy-nine women with symptomatic pregnancy of unknown location.
INTERVENTION(S): None.
MAIN OUTCOME MEASURE(S): Slope of log hCG; days and visits to final diagnosis.
RESULT(S): Of women with an EP, 60% initially exhibited an increase in hCG values, with a median slope of 32% increase in 2 days; 40% of subjects initially had an hCG decrease, with the median slope calculated as a 15% decline in 2 days. In total, the hCG curves in 27% of women diagnosed with EP resembled that of a growing IUP or SAB. Of the EP hCG curves, 16% demonstrated a change in the direction of the slope of the curve. This was more common in African Americans and less evident in Hispanics. Furthermore, it was associated with more clinical visits and days until final diagnosis.
CONCLUSION(S): The rate of change in serial hCG values can be used to distinguish EP from an IUP or SAB in only 73% of cases. The number of women who had a change in direction of serial hCG values was associated with race and ethnicity.
研究异位妊娠（EP）患者中 hCG 曲线的多样性，并了解其何时可能与宫内妊娠（IUP）或自然流产（SAB）的曲线相似。
回顾性队列研究。
三所大学医院。
179 例有不明位置妊娠症状的女性。
无。
hCG 对数斜率；到达最终诊断的天数和就诊次数。
60%的 EP 患者最初表现为 hCG 值增加，中位数斜率为 2 天内增加 32%；40%的患者最初 hCG 值下降，中位数斜率计算为 2 天内下降 15%。总共，27%被诊断为 EP 的女性的 hCG 曲线类似于生长中的 IUP 或 SAB。EP hCG 曲线中有 16%显示曲线斜率方向发生变化。这种情况在非裔美国人中更为常见，在西班牙裔中则不太明显。此外，它与更多的临床就诊次数和到达最终诊断的天数有关。
只有 73%的情况下，hCG 值的变化率可用于区分 EP 与 IUP 或 SAB。hCG 值序列方向发生变化的女性数量与种族和民族有关。
