Early and late half‐life of human chorionic gonadotropin as a predictor of persistent trophoblast after laparoscopic conservative surgery for tubal pregnancy

Abstract

Early and late half-lives of hCG do not identify all women at risk for persistent ectopic pregnancy. To exclude persistent trophoblast, postoperative serum hCG determination should be performed until levels are undetectable.

Clinical characteristics of persistent ectopic pregnancy after salpingostomy and influence on ongoing pregnancy

“…In the PEP group, the median duration from the patient presenting with lower abdominal pain to undergoing surgery was 5.16 days (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21). Eight women presented with slight pain, 44 with obvious pain and 12 with rectal tenesmus.…”

“…Billieux et al carried out a prospective study of conservative surgery in EP in early (0-2 days) and late stage (2-7 days) and diagnosed two and nine cases of PEP, respectively. 20 In the late stage, two patients were diagnosed with false positive and one case exhibited an increased hCG level (false negative) on POD 7. Early or late stage monitoring of hCG level is not effective in all patients, but that the hCG level should be monitored until it returns to normal in order to diagnose PEP.…”

“…Billieux et al . carried out a prospective study of conservative surgery in EP in early (0–2 days) and late stage (2–7 days) and diagnosed two and nine cases of PEP, respectively . In the late stage, two patients were diagnosed with false positive and one case exhibited an increased hCG level (false negative) on POD 7.…”

Predicting Success of Laparoscopic Salpingostomy for Ectopic Pregnancy

“…17,[32][33][34][35][36] Nevertheless, different studies have yielded conflicting results. 19,37 This discrepancy may be explained by the different definitions of failure, patient selection, and different operative skills.…”

Hysteroscopy and suction evacuation of cesarean scar pregnancies: A case report and review

“…When surgical ectopic removal is performed, regardless of its location, with no residual chorionic villi, the serum hCG level should fall as a function of its half-life. The serum half-life of hCG is approximately 24 h. So, 24 h after the surgical procedure, the hCG level should be no more than one-half of its pre-surgical level, and should continue to fall by one-half for each subsequent 24 h. 24 A fall less than that would suggest the possibility of trophoblastic tissue remaining: i.e. persistent ectopic pregnancy.…”