Carvalho Lucas Ribeiro Borges de, Assis Rafaela Tessaro de, Braga Antônio, Bonetti Tatiana Carvalho de Souza, Araujo Júnior Edward, Mattar Rosiane, Sun Sue Yazaki
Universidade Federal de São Paulo, Escola Paulista de Medicina, Department of Obstetrics - São Paulo (SP), Brazil.
Universidade Federal do Rio de Janeiro, Department of Obstetrics and Gynecology - Rio de Janeiro (RJ), Brazil.
Rev Assoc Med Bras (1992). 2024 Dec 16;70(12):e20240659. doi: 10.1590/1806-9282.20240659. eCollection 2024.
The aim of this study was to evaluate the serum hCG level in the differential diagnosis between non-molar miscarriage and complete hydatidiform mole in<11 weeks gestation.
This was a retrospective collaborative cohort study. This study included women with gestational age<11 weeks, with ultrasound evidence of failed pregnancy and available serum hCG pre-uterine evacuation, divided into two groups: the non-molar miscarriage group and the complete hydatidiform mole group. Serum hCG levels were compared according to gestational age. Statistical analysis used a nonparametric test with a 5% significance level (p<0.05).
In total, 416 patients were included, out of which 79 were included in the non-molar miscarriage group and 337 in the complete hydatidiform mole group. The calculated power of the sample was more than 80%. Data analysis showed that the 75th quartile of the median in the non-molar miscarriage group was always lower than the 25th quartile of the median in the complete hydatidiform mole group [9,721 mUI/mL/16,435 mUI/mL (6-7 weeks), 20,229 mUI/mL/64,911 mUI/mL (8-9 weeks), and 29,633 mUI/mL/126,278 mUI/mL (10-11 weeks), respectively; p<0.001].
Facing failed pregnancies, hCG>16,435 mUI/mL at 6-7 weeks, hCG>64,911 mUI/mL at 8-9 weeks, and hCG >126,278 mUI/mL at 10-11 weeks were most prevalent on complete hydatidiform mole diagnosis. On the contrary, hCG<30,000 mUI/mL at 10-11 weeks was most prevalent in non-molar miscarriage diagnosis.
本研究旨在评估妊娠11周以内非葡萄胎流产与完全性葡萄胎鉴别诊断中的血清人绒毛膜促性腺激素（hCG）水平。
这是一项回顾性协作队列研究。本研究纳入妊娠11周以内、超声检查显示妊娠失败且子宫排空术前有可用血清hCG的女性，分为两组：非葡萄胎流产组和完全性葡萄胎组。根据孕周比较血清hCG水平。采用非参数检验进行统计分析，显著性水平为5%（p<0.05）。
共纳入416例患者，其中非葡萄胎流产组79例，完全性葡萄胎组337例。计算得出样本效能超过80%。数据分析显示，非葡萄胎流产组中位数的第75四分位数始终低于完全性葡萄胎组中位数的第25四分位数[分别为9,721 mUI/mL/16,435 mUI/mL（6 - 7周）、20,229 mUI/mL/64,911 mUI/mL（8 - 9周）和29,633 mUI/mL/126,278 mUI/mL（10 - 11周）；p<0.001]。
面对妊娠失败情况，6 - 7周时hCG>16,435 mUI/mL、8 - 9周时hCG>64,911 mUI/mL以及10 - 11周时hCG>126,278 mUI/mL在完全性葡萄胎诊断中最为常见。相反，10 - 11周时hCG<30,000 mUI/mL在非葡萄胎流产诊断中最为常见。
