Extrauterine pregnancy
| Description | Beta-HCG, progesterone (estradiol) Normal intrauterine pregnancy: In normal pregnancies, beta-HCG increases by at least 66 % within 48 hours. Usually the doubling time of beta-HCG-concentration is 1,6 to 2 days in the 4th-5th week of pregnancy and 2-3 days in the 5th-6th week of pregnancy. If there is no sonographic depiction of chorionic cavity with beta-HCG-level > 1500 mlU/ml, miscarriage or extrauterine pregnancy is likely. On suspicion of extrauterine pregnancy (EU) or miscarriage: Repetitive beta-HCG-evaluations are recommended. In extrauterine pregnancies beta-HCG-levels are low for the week of pregnancy, they rise only slowly, remain constant or even decrease. If there is no sonographic proof of intrauterine pregnancy with beta-HCG-level of > 7000 IU/l there is a strong suspicion of extrauterine pregnancy. If the second value does not reach double the value after 2-3 days (see above) and there are low estradiol- and progesterone-levels (< 200 ng/l or 14 µg/l), then there is the suspicion of extrauterine pregnancy or hydatid mole. A single progesterone value may be sufficient for diagnosis of miscarriage. A progesterone-level of 25 µg/l or more rules out extrauterine pregnancy (97,5 % sensitivity). In case of progesterone-levels between 5 and 25 µg/l the viability needs to be confirmed by ultrasound. |
