Human Reproduction, Vol. 11, No. 4, pp. 881-888, 1996
© 1996 European Society of Human Reproduction and Embryology
research-article |
The role of a single free 
-human chorionic gonadotrophin measurement in the diagnosis of early pregnancy failure and the prognosis of fetal viability
1Department of Obstetrics and Gynaecology, Royal Liverpool University Hospital Prescot Street, Liverpool L7 8XP 2Endocrine Laboratory, University Department of Clinical Chemistry, Alder Hey Hospital Eaton Road, Liverpool L12 2AP, UK
Correspondence: 3To whom correspondence should be addressed at: The University Department of Clinical Chemistry, Duncan Building, Royal Liverpool University Hospital, Prescot Street, PO Box 147, Liverpool L69 3BX, UK
This prospective controlled study investigated the concentrations of free 
-human chorionic gonadotrophin (HCG) subunit in 554 women with a singleton intrauterine or tubal pregnancy. They presented with vaginal bleeding and/or abdominal pain in the first 18 weeks of pregnancy. The control group comprised 156 women with musculo-skeletal pain and no vaginal bleeding. Their pregnancies continued to term. The study group comprised 398 women (141 threatened-continuing pregnancies, 37 threatened-miscarriages, 185 non-continuing pregnancies and 35 tubal pregnancies). Free -HCG concentrations were significantly lower in the non-continuing, threatened-miscarriage and tubal pregnancy groups [mean 4.62, 6.50 and 4.27 ng/ml respectively; 95% confidence interval (CI) 3.75–-5.69, 4.46–9.48 and 2.92–6.2 respectively] than in the control and threatened-continuing groups (mean 41.61 and 48.22 ng/ml respectively; 95% CI 34.53–50.13 and 42.03–55.32 respectively) (P < 0.001 in all cases). A cut-off value at 20 ng/ml was found to differentiate between the ‘viable’ (control and threatened-continuing) and the ‘abnormal’ (non-continuing, threatened-miscarriage and tubal) pregnancies, with 88.3% sensitivity and 82.6% positive predictive value. An excellent diagnostic and prognostic usability of free HCG was confirmed by a receiver operating characteristic curve plot In conclusion, a single serum free -HCG measurement taken in early pregnancy is valuable in the immediate diagnosis of early pregnancy failure and the long-term prognosis of viability.
Key words:
early pregnancy failure/fetal viability/free -HCG/normal early pregnancy/tubal pregnancy
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