Clinical and Experimental Obstetrics & Gynecology (CEOG) is published by IMR Press from Volume 47 Issue 1 (2020). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.
Slow rising serial chorionic gonadotropins predict poor pregnancy outcome despite sonographic viability
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 betahCG 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.