Predictive Role of Beta hCG for The Outcome of The Tubal and Cesarean Scar Ectopic Pregnancy: A Retrospective Study

Abstract

Background: Ectopic pregnancy is associated with higher maternal morbidity and mortality. Early diagnosis and outcome predictors represented a crucial option to reduce such morbidity and mortality.Aim of the work: To evaluate the value of serum β-hCG for clinical outcome prediction in tubal and cesarean scar ectopic pregnancy.Patients and Methods: This retrospective study of 192 ectopic pregnancies [tubal and cesarean section scar]. The collected data included patient demographics, obstetric and past history. Data of clinical examination were also recorded. Serum concentration of β-hCG at admission and after 48 hours were documented. The ultrasound examination was performed to define of the site of ectopic and to ensure empty uterine cavity. All patients were followed-up for their outcome of ectopic pregnancy and for 2 months after discharge.Results: The outcome was significantly different between both groups [group II managed mainly by surgical wedge resection [96.9%] compared to none in group I. The highest β-hCG values were recorded for surgical wedge resection. 55.4% of those with doubling had no surgical wedge resection compared to 44.9% of those without doubling. The response to medical treatment was significantly associated with non-doubling of β-hCG [33.9% vs 12.3%]. β-hCG in tubal and cesarean scar ectopic pregnancy showed good predictive power [AUC > 0.75] with 100.0% sensitivity.Conclusion: High β-hCG at admission and after 48 hours and specifically doubling of values are significantly associated with low response to medical treatment in tubal ectopic pregnancy.

Keywords

• ectopic pregnancy
• cesarean scar
• tubal
• β-hcg