Improved diagnosis of pregnancy-related gynaecological emergencies by rapid human chorionic gonadotrophin beta-subunit assay.

A pregnancy-related disorder was identified by a rapid radioimmunoassay of serum chorionic gonadotrophin (hCG-RIA) in 122 out of 470 women (26 per cent) with lower abdominal pain or bleeding, while a routine pregnancy test in urine was positive in only 7 per cent of these cases. In 49 patients with ectopic pregnancy the rapid hCG-RIA was positive in 90 per cent as compared with 13 per cent for the routine pregnancy test. In patients with evidence of intrauterine pregnancy (66 cases) the rapid hCG-RIA was positive in 98 per cent and the routine pregnancy test in 38 per cent. The clinical sensitivity of the hCG-RIA was 95 per cent, specificity 96 per cent and predictive value 89 per cent. The test can improve the efficiency of the routine diagnosis of early intra- and extrauterine pregnancy-related disorders.