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Slow rising serial chorionic gonadotropins predict poor pregnancy outcome despite sonographic viability
1The University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School at Camden, Cooper Hospital/University Medical Center, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology & Infertility, Camden, NJ, USA.
Purpose:
To determine the prognosis of women with slow rising beta-hCG levels when viability is detected by ultrasound.
Methods:
Serum beta-hCG levels were obtained every two to three days in the early first trimester. Doubling-time (DT) of beta-hCG levels was defined as DT exceeding 3.2 days. Sonography was performed at eight weeks and then after 12 weeks.
Results:
There were 158 consecutive pregnancies evaluated and 111 (70%) had normal rising beta-hCG levels, viable ultrasound at eight weeks, and viable pregnancies after 12 weeks. There were 22 pregnancies with slow rising beta-hCG levels (13.9%) with 16 (72.7%) showing viability at eight weeks but not after the first trimester. A sac-crown rump length discrepancy with a sac smaller than normal was found in 11 of these 16 (68.7%) women.
Conclusions:
Patients with slow rising beta-hCG levels should not be given an optimistic prognosis even if viability is demonstrated at eight weeks.