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

Billieux, Marie-Hélène; Petignat, Patrick; Anguenot, Jean-Luc; Campana, A.; Bischof, P.

doi:10.1080/j.1600-0412.2003.00154.x

Cited by 4 publications

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“…Bilieux et al [12] reported a sensitivity of 90% and specificity of 97% using late half-life of b-hCG (between 2 and 7 days postoperatively) to identify patients with PEP. Furthermore, Abe et al [13] identified a decline in serum b-hCG level during postoperative days 5 and 6 as an important marker of PEP.…”

Section: Discussionmentioning

confidence: 99%

Factors Predicting Persistent Ectopic Pregnancy After Laparoscopic Salpingostomy or Salpingotomy for Tubal Pregnancy: A Retrospective Cohort Study

Ting

Lin

Hsiao

2019

Journal of Minimally Invasive Gynecology

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To identify factors predictive of persistent ectopic pregnancy (PEP) in women who have undergone laparoscopic salpingostomy or salpingotomy for tubal pregnancy. Design: Retrospective cohort study (Canadian Task Force classification II-2). Setting: Tertiary referral center. Patients: Ninety-nine women who underwent laparoscopic tubal preservation surgery for ectopic pregnancy. Interventions: Seventy women underwent laparoscopic salpingostomy, and the remaining 29 women underwent laparoscopic salpingotomy. Measurements and Main Results: Factors predicting PEP were evaluated. The change in serum beta human chorionic gonadotropin (b-hCG) levels from baseline observed between postoperative days 5 and 10 (ChCGD5-10) was a predictor of PEP (odds ratio [OR], 0.80; p = .01). Based on receiver operating characteristic (ROC) curve analysis, a cutoff value of 93.1% was determined, with an area under the ROC curve of 0.95 (sensitivity, 85.7%; specificity, 100%). Nonetheless, when considering perioperative variables only, body mass index (BMI) was identified as a predictor of PEP (OR, 0.71; p = .03). Based on the ROC analysis, a BMI cutoff value of ≤ 22 kg/m 2 was determined, with an ROC area of 0.73 (sensitivity, 43.2%; specificity, 100%). In addition, a higher baseline b-hCG level (hazard ratio [HR], 1.0002; p = .009) and left tubal pregnancy (HR, 6.46; p = .03) were predictive of recurrent ectopic pregnancy. There were no differences in the perioperative outcomes, PEP rates, or subsequent intrauterine pregnancy rates between the salpingostomy and salpingotomy groups. In addition, surgical method was not a predictor of recurrent ectopic pregnancy. Conclusions: ChCGD5-10 was identified as a predictor for PEP, suggesting that it might be more clinically useful for the follow-up of PEP. When considering perioperative variables only, BMI was a predictor for PEP. In addition, there was no significant difference in clinical outcomes between the salpingostomy and salpingotomy groups.

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Section: Discussionmentioning

confidence: 99%

Factors Predicting Persistent Ectopic Pregnancy After Laparoscopic Salpingostomy or Salpingotomy for Tubal Pregnancy: A Retrospective Cohort Study

Ting

Lin

Hsiao

2019

Journal of Minimally Invasive Gynecology

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“…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.…”

Section: Discussionmentioning

confidence: 99%

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

Zhang

Chen

et al. 2017

J of Obstet and Gynaecol

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AimThe aim of this study was to assay the clinical characteristics of persistent ectopic pregnancy (PEP) and its influence on ongoing pregnancy.MethodsWe retrospectively reviewed 2498 patients who received salpingostomies as primary management for ectopic pregnancies from January 2004 to December 2009, using medical records and telephone inquiries. Clinical characteristics of the 52 patients (2.08%) who were diagnosed with PEP after salpingostomy were compared with those who received satisfactory treatment. The odds ratios and 95% confidential intervals were calculated for each variable by univariate and (for significantly different factors) multivariate analysis.ResultsPreoperatively, patients with PEP after salpingostomy significantly differed from the non‐PEP patients in gestational age, mass size and pelvic adhesiolysis. Serum β‐human chorionic gonadotropin levels in PEP patients were monitored after surgery, which had declined by 28.31% on postoperative day (POD) 4, 40.22% on POD 7, 51.46% on POD 10 and 53.43% on POD 21. Repeat ectopic pregnancy (REP) tended to occur more frequently in PEP patients (PEP: 5 cases, 10.20%; non‐PEP: 4 cases, 2.80%; P = 0.034). Multivariate analysis showed that pelvic adhesions and PEP were the strongest independent predictors of REP.ConclusionGestational age, mass size and pelvic adhesions were significantly correlated with PEP. PEP was an independent prognostic factor for REP. However, a multicenter study is needed to support and extend our findings.

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“…Billieux ve ark. β-HCG'nin erken ve geç yarı ömürlerinin konservatif cerrahi sonrası persistan trofoblastik aktiviteyi tahmin etmedeki rolünü araştırırken, tüm hastaları tanımada yeterli olmadığı için yine de yarı ömür yerine β-HCG değerleri sıfırlanana kadar takip yapılması gerekliliği sonucuna varmışlardır [7]. Tüm bu çalışmalarda amaç, özellikle bizim olgumuzda olduğu gibi uzun dönem takibe gelmesi gerektiği halde takiplerini aksatan hastalarda morbiditeleri önlemek için erken dönemde persistans riskini tahmin etmektir.…”

Section: Discussionunclassified

Persistent ectopic pregnancy after milking procedure: Case report

Kayatas¹

2014

Diclemedj

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Ectopic pregnancy is the settlement of the pregnancy product at any site other than the endometrium. The incidence of ectopic pregnancy have increased in the last 20 years. Increased frequency and early diagnosis has led to conservative treatment methods to become more favorable. Follow-up, medical management and surgical managements are considered as conservative methods. As salpingostomy is the most common conservative surgical method, milking is considered as an alternative conservative surgical method. The most important complication of the conservative surgery is the persistence of ectopic pregnancy because of the residual trophoblastic tissue. Since the prediction of the persistent ectopic pregnancy is difficult after the conservative surgery, β-HCG follow up is so important for early diagnosis. In this case report we have discussed the case of the patient who admitted to our clinic with persistent ectopic pregnancy with acute abdomen, after the treatment with milking procedure whom than treated by salpingectomy procedure.

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

Cited by 4 publications

References 0 publications

Factors Predicting Persistent Ectopic Pregnancy After Laparoscopic Salpingostomy or Salpingotomy for Tubal Pregnancy: A Retrospective Cohort Study

Factors Predicting Persistent Ectopic Pregnancy After Laparoscopic Salpingostomy or Salpingotomy for Tubal Pregnancy: A Retrospective Cohort Study

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

Persistent ectopic pregnancy after milking procedure: Case report

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