How important is serum beta-hCG in the management of ectopic pregnancy?

Renukesh, Sandya; Rai, Lavanya; Hebbar, Shripad

doi:10.5455/2320-1770.ijrcog20150414

Cited by 2 publications

(1 citation statement)

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“…In the present study, women with a declining trend between day 0 and day 4 with lower initial β-hCG (1000-3000 mIU/mL) had a 100% success rate and women with a declining trend with higher initial β-hCG 3001-5000 mIU/mL had a success rate of 60-67%. Renukesh et al 13 demonstrated that the declining trend of β-hCG between day 0 and day 4 was associated with a 75% success rate.…”

Section: Discussionmentioning

confidence: 99%

Initial and Day Four β-hCG Levels as Predictors of Outcome of Single-dose Methotrexate Therapy in Medical Management of Tubal Ectopic Gestation

Biswas¹,

Kumari²,

Yadav³

et al. 2022

Indian Journal of Medical Biochemistry

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Introduction: Ectopic pregnancy is defined as the implantation of a fertilized ovum outside the endometrial cavity. The most common site is the fallopian tube. The incidence of ectopic pregnancy is 1-2% of all pregnancies. Methotrexate is the most commonly used drug for the medical management of ectopic pregnancy. It is a folic acid antagonist that prevents the growth of rapidly dividing cells including trophoblasts and fetal cells by interfering with DNA synthesis. Aim and objective: To study initial and day 4 β-hCG levels as predictors of outcome of single-dose methotrexate therapy in the medical management of ectopic pregnancy. Materials and methods: Thirty patients after confirmed diagnoses of tubal ectopic pregnancy were enrolled in the study. β-hCG was estimated using a sequential two-step immunoenzymatic (sandwich) assay. Results: Out of 30 women who received inj MTX on day 0, 19 (63.3%) women were treated successfully with a single dose of methotrexate (group I), 8 (26.6%) women required a second dose of methotrexate, and 3 (10%) women required surgery. Women who required a second dose or surgery were treatment failure (group II) (36.6%) with a single-dose methotrexate regimen. The mean initial β-hCG β-hCG level was 2294.92 ± 1162.93 mIU/mL in group I and 3831.18 ± 1066.83 mIU/mL in group II. The difference of mean was statistically significant between group I and group II on day 0, day 4, and day 7. Conclusion:Results in the present study favor therapeutic intervention with a second dose of methotrexate on day 4 against day 7 as in the current protocol in women with a rising trend of β-hCG between day 0 and day 4. However, due to the small sample size, further studies are needed to validate these findings.

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Section: Discussionmentioning

confidence: 99%

Initial and Day Four β-hCG Levels as Predictors of Outcome of Single-dose Methotrexate Therapy in Medical Management of Tubal Ectopic Gestation

Biswas¹,

Kumari²,

Yadav³

et al. 2022

Indian Journal of Medical Biochemistry

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Advancing diagnostics: integrating microRNA profiling and protein markers in ectopic pregnancy detection

Selvarajan,

Ramalingam,

Senthil Kumar

2024

gocm

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IntroductionEctopic pregnancy (EP) poses significant health risks, particularly in developing nations, necessitating improved diagnostic methods. This study aimed to explore potential biomarkers for EP diagnosis.MethodsA case–control study was conducted at the Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu. It included 140 EP cases and 140 pregnant controls, aged 19–38 years, attending routine visits. Serum samples were analysed for beta-human chorionic gonadotropin (β-hCG), progesterone, soluble fms-like tyrosine kinase-1 (sFLT-1) and eight microRNAs (miRs).ResultsDifferential expression of biomarkers was observed in EP cases. Four miRs (hsa-miR-141, hsa-miR-218, hsa-miR-519d and hsa-miR-873) were downregulated, and four miRs (hsa-miR-223, hsa-miR-517a, hsa-miR-523 and hsa-miR-323-3p) were upregulated. Statistically significant expression fold changes were noted (p<0.05), except for hsa-miR-141 and hsa-miR-218. miR-519d exhibited promising diagnostic potential with the highest specificity (97.1%) and a sensitivity of 47.1%. sFLT-1, as an individual marker, demonstrated a sensitivity of 98.6% and a specificity of 90%. The combination of sFLT-1 and miR-519d significantly enhanced the sensitivity to 100% with a specificity of 87.1%.ConclusionsThe combination of miR-519d and sFLT-1 emerges as a promising diagnostic tool for EP, offering a sensitivity of 100% and a specificity of 87.1%. These findings underscore the potential of biomarker-based approaches in improving EP diagnosis, especially in resource-limited settings. Further validation and clinical implementation studies are warranted to corroborate these findings and enhance EP management strategies.

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How important is serum beta-hCG in the management of ectopic pregnancy?

Cited by 2 publications

References 9 publications

Initial and Day Four β-hCG Levels as Predictors of Outcome of Single-dose Methotrexate Therapy in Medical Management of Tubal Ectopic Gestation

Initial and Day Four β-hCG Levels as Predictors of Outcome of Single-dose Methotrexate Therapy in Medical Management of Tubal Ectopic Gestation

Advancing diagnostics: integrating microRNA profiling and protein markers in ectopic pregnancy detection

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