Peracheh Mahboubeh, Teymouri Batool, Noori Narjes, Arbabzadeh Taraneh, Ghasemi Marzieh
Department of Obstetrics and Gynecology, Zahedan University of Medical Sciences, Zahedan, Iran.
Department of Obstetrics and Gynecology, Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran E-mail:
Qatar Med J. 2021 Jul 12;2021(2):22. doi: 10.5339/qmj.2021.22. eCollection 2021.
Clinical methods that are generally used to evaluate the completeness of medical abortion are not reliable. Ultrasound imaging and beta-human chorionic gonadotropin (β-hCG) measurements are used to diagnose completed medical abortion, but a precise evaluation of these two methods has shown contradictory results. The purpose of this study is to evaluate the agreement of serum β-hCG measurement and ultrasound imaging to confirm complete medical abortion.
This study was conducted on pregnant women who had been referred to our center for medical abortion from 2015 to 2017. All cases occurred in the first trimester of pregnancy. They obtained one or two doses of vaginal misoprostol for medical abortion. Success rate of medical abortion was measured by both transvaginal ultrasound imaging and consecutive serum β-hCG measurements two to four weeks after initial treatment.
Among the 275 women who completed the study, complete medical abortion was confirmed by serum β-hCG in 231 women (84.3%) and transvaginal ultrasound imaging in 195 women (70.8%) after two weeks. All remaining cases completed the medical abortion after an additional two weeks, confirmed by both transvaginal ultrasound imaging and serum β-hCG. The sensitivity, specificity, positive, and negative predictive values of β-hCG were 95.2%, 86.7%, 84%, and 70%, respectively; and these values for transvaginal ultrasound imaging were 68.5% 64.5%,77%, and 30.%, respectively, for the diagnosis of completed medical abortion.
Serum β-hCG measurement is as effective as transvaginal ultrasound imaging to confirm successful medical abortion in early pregnancy.
一般用于评估药物流产完整性的临床方法并不可靠。超声成像和β-人绒毛膜促性腺激素（β-hCG）测量用于诊断药物流产是否完成，但对这两种方法的精确评估显示结果相互矛盾。本研究的目的是评估血清β-hCG测量与超声成像在确认药物流产完全成功方面的一致性。
本研究针对2015年至2017年转诊至本中心进行药物流产的孕妇。所有病例均发生在妊娠早期。她们接受了一剂或两剂阴道米索前列醇进行药物流产。通过经阴道超声成像和初始治疗后两至四周连续的血清β-hCG测量来衡量药物流产的成功率。
在完成研究的275名女性中，两周后血清β-hCG确认231名女性（84.3%）药物流产完全成功，经阴道超声成像确认195名女性（70.8%）药物流产完全成功。所有其余病例在再过两周后完成药物流产，经阴道超声成像和血清β-hCG均确认。β-hCG诊断药物流产完全成功的敏感性、特异性、阳性预测值和阴性预测值分别为95.2%、86.7%、84%和70%；经阴道超声成像的这些值分别为68.5%、64.5%、77%和30%。
血清β-hCG测量在确认早期妊娠药物流产成功方面与经阴道超声成像同样有效。
