[Risk factors and predictors of persistent ectopic pregnancy after interstitial pregnancy surgery]

Area of Science:

• Reproductive Medicine
• Gynecologic Surgery
• Ectopic Pregnancy Research

Background:

• Interstitial pregnancy is a rare form of ectopic pregnancy with significant risks.
• Persistent ectopic pregnancy (PEP) can occur after surgical management of interstitial pregnancy.
• Identifying early predictors of PEP is crucial for timely intervention and improved patient outcomes.

Purpose of the Study:

• To investigate the factors associated with persistent ectopic pregnancy (PEP) following surgical treatment of interstitial pregnancy.
• To identify early predictors of PEP in patients who have undergone surgery for interstitial pregnancy.
• To evaluate the diagnostic performance of the postoperative to preoperative serum β-human chorionic gonadotropin (β-hCG) ratio in predicting PEP.

Main Methods:

• Retrospective analysis of clinical data from patients with interstitial pregnancy who underwent surgery.
• Propensity score matching (PSM) was used to compare patients with and without PEP.
• Analysis included patient demographics, surgical methods, and serial serum β-hCG levels, with ROC curve analysis for predictive value.

Main Results:

• A maximum lesion diameter ≤ 2.6 cm was significantly associated with an increased risk of PEP (P=0.025).
• The ratio of 24-48 hours postoperative to preoperative serum β-hCG was significantly higher in the PEP group (median 52.9% vs. 31.5%, P=0.001).
• The ratio of 24-48 hours postoperative β-hCG to preoperative β-hCG > 48.5% demonstrated high sensitivity (87.5%) and specificity (93.1%) for predicting PEP (AUC=0.892).

Conclusions:

• A smaller maximum lesion diameter (≤ 2.6 cm) is a related factor for postoperative persistent ectopic pregnancy after interstitial pregnancy surgery.
• The ratio of 24-48 hours postoperative to preoperative serum β-hCG is a valuable early predictor for postoperative PEP.
• This β-hCG ratio can serve as a reference index for predicting PEP and guiding subsequent treatment strategies.