Irani Mohamad, Elias Rony T, Pereira Nigel, Gunnala Vinay, Rosenwaks Zev
Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, USA.
J Obstet Gynaecol Res. 2016 Dec;42(12):1886-1888. doi: 10.1111/jog.13127. Epub 2016 Oct 8.
With the availability of the highly sensitive β-human chorionic gonadotropin (β-hCG) assays, all pregnancies, including ectopic pregnancies (EP), are expected to have detectable serum β-hCG at 4 weeks' gestation or 9 days following blastocyst transfer. To our knowledge, this is the first report of a woman who underwent in vitro fertilization, had undetectable serum β-hCG 9 days after blastocyst transfer, and was then diagnosed with a ruptured abdominal EP and intra-abdominal bleeding 19 days later. This case highlights that the rise in serum β-hCG might be delayed in abdominal EP compared to intrauterine pregnancy. This delay should raise the suspicion for EP, thus meriting close monitoring. Moreover, in the absence of menstruation, an undetectable serum β-hCG 9 days post-blastocyst transfer should prompt β-hCG measurement in 2-3 days to avoid the misdiagnosis of an EP.
随着高灵敏度β-人绒毛膜促性腺激素（β-hCG）检测方法的出现，所有妊娠，包括异位妊娠（EP），预计在妊娠4周或囊胚移植后9天时血清β-hCG可被检测到。据我们所知，这是首例接受体外受精的女性，在囊胚移植9天后血清β-hCG检测不到，19天后被诊断为腹腔内EP破裂并腹腔内出血的报告。该病例突出表明，与宫内妊娠相比，腹腔内EP血清β-hCG的升高可能会延迟。这种延迟应引起对EP的怀疑，因此值得密切监测。此外，在无月经的情况下，囊胚移植后9天血清β-hCG检测不到应在2 - 3天内进行β-hCG测量，以避免EP的误诊。
