Tinga D J, van Lier J J, de Bruijn H W
Department of Obstetrics and Gynaecology, State University Hospital, Groningen, The Netherlands.
Acta Obstet Gynecol Scand. 1990;69(6):505-9. doi: 10.3109/00016349009013327.
In a group of 20 asymptomatic women at increased risk for ectopic pregnancy, serum analyses were conducted prospectively early in pregnancy (amenorrhea less than or equal to 45 days) at 2-4-day intervals, to examine the rate of increase in hCG values. The initial serum hCG level, which was determined at the time of the first transvaginal ultrasound examination, was below the discriminatory zone of 1000 IU/l (2nd International Standard). In 8 out of the 9 women who were ultimately diagnosed as having an ectopic pregnancy, the increase in hCG progressed only slowly, with a doubling time exceeding 2.2 days. This slow hCG increase occurred in 2 out of the 11 women who were ultimately diagnosed as having an intra-uterine pregnancy; both women subsequently had an early spontaneous abortion. When Lindblom's hCG score was applied retrospectively to distinguish between intra-uterine and ectopic pregnancies, the hCG increase in all the ectopic pregnancies was below 190 IU/l per day and in 10 of the 11 women with an intra-uterine pregnancy above 190 IU/l per day. A slower rate of increase was observed in only one woman with an intra-uterine pregnancy; she had a spontaneous abortion. The doubling time of hCG and the hCG score are useful diagnostic aids in cases where transvaginal ultrasound has not (yet) given a definite answer regarding the presence of an intra-uterine pregnancy.
在一组20名异位妊娠风险增加的无症状女性中，在妊娠早期（闭经小于或等于45天）前瞻性地每隔2 - 4天进行血清分析，以检查hCG值的上升速率。首次经阴道超声检查时测定的初始血清hCG水平低于1000 IU/l（第2国际标准）的鉴别阈值。在最终被诊断为异位妊娠的9名女性中，有8名hCG的上升进展缓慢，翻倍时间超过2.2天。在最终被诊断为宫内妊娠的11名女性中，有2名出现了hCG的缓慢上升；这两名女性随后均发生了早期自然流产。当回顾性应用Lindblom的hCG评分来区分宫内妊娠和异位妊娠时，所有异位妊娠的hCG每日上升低于190 IU/l，而11名宫内妊娠女性中有10名的hCG每日上升高于190 IU/l。只有一名宫内妊娠女性观察到上升速率较慢；她发生了自然流产。在经阴道超声尚未（或仍未）就宫内妊娠的存在给出明确答案的情况下，hCG的翻倍时间和hCG评分是有用的诊断辅助手段。
