Human chorionic gonadotropin ratio of hemoperitoneum versus venous serum improves early diagnosis of ectopic pregnancy.

Overview

OBJECTIVE: To analyze the value of the hCG ratio of peritoneal serum versus venous serum (R(P/V)) for early diagnosis and prognostic evaluation of ectopic pregnancy (EP). DESIGN: Retrospective clinical study. SETTING: University hospital. PATIENT(S): One hundred three women with hemoperitoneum and positive urine hCG tests underwent laparoscopy or laparotomy. INTERVENTION(S): Venous serum and peritoneal serum samples were obtained; ultrasound was performed in all the patients; dilatation and curettage was used in 28 patients. MAIN OUTCOME MEASURE(S): Quantitative hCG and R(P/V). RESULT(S): The R(P/V) in EP (5.55 +/- 4.32) is apparently greater than that in hemoperitoneum with intrauterine pregnancy (hIUP; 0.61 +/- 0.18). The median R(P/V) is 4.07 in the EP group versus 0.60 in the hIUP group, with a suggested threshold value of 1.0 for their differential diagnosis. Moreover, the R(P/V) of EP shows the dominant difference between the patients with active bleeding (8.03 +/- 3.29, n = 24) and the patients without active bleeding (4.59 +/- 3.88, n = 16) when the hCG level of venous serum is more than 1500 U/L. CONCLUSION(S): R(P/V) could instantly diagnose ectopic pregnancy and differentiate it from hIUP.