Mehta T S, Levine D, Beckwith B
Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.
Radiology. 1997 Nov;205(2):569-73. doi: 10.1148/radiology.205.2.9356647.
To determine whether a human chorionic gonadotropin (hCG) level of 2,000 mIU/mL is a reasonable threshold for diagnosing ectopic pregnancy in the absence of ultrasound (US) findings of intrauterine pregnancy (IUP) and thus to prevent inappropriate treatment that will result in the loss of an otherwise normal pregnancy in women with early IUPs.
The authors reviewed the medical records of and US scans obtained in 676 patients in whom ectopic pregnancy was clinically suspected between January 1, 1994, and December 31, 1995.
Five hundred forty-eight patients had evidence of a normal or abnormal IUP. Fifty-one (40%) of the 128 patients without evidence of an IUP had an hCG level of more than 2,000 mIU/mL. Of these 51 patients, 15 (29%) were treated for ectopic pregnancy; 17 (33%) were not immediately treated for ectopic pregnancy and had a normal IUP at follow-up US.
An hCG level of 2,000 mIU/mL without US findings of IUP, while suggestive of an abnormal pregnancy, is not diagnostic. Per the results of recent studies, it is reasonable to closely follow up rather than treat many of these early, stable cases of ectopic pregnancy.
确定在无宫内妊娠（IUP）超声（US）检查结果的情况下，人绒毛膜促性腺激素（hCG）水平2000 mIU/mL是否为诊断异位妊娠的合理阈值，从而避免不恰当的治疗导致早期宫内妊娠妇女失去原本正常的妊娠。
作者回顾了1994年1月1日至1995年12月31日期间临床怀疑异位妊娠的676例患者的病历及超声检查结果。
548例患者有宫内妊娠正常或异常的证据。128例无宫内妊娠证据的患者中，51例（40%）hCG水平超过2000 mIU/mL。在这51例患者中，15例（29%）接受了异位妊娠治疗；17例（33%）未立即接受异位妊娠治疗，随访超声显示宫内妊娠正常。
无宫内妊娠超声检查结果而hCG水平为2000 mIU/mL，虽提示妊娠异常，但不能确诊异位妊娠。根据近期研究结果，对许多早期、病情稳定的异位妊娠病例进行密切随访而非治疗是合理的。
