Contraception · 2025
Change in hCG levels after very early medication abortion for pregnancy of unknown location or probable intrauterine pregnancy.
СтатьяМногоцентровое исследованиеРандомизированное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Jar-Allah Tagrid, Brandell Karin, Gyllenberg Frida, Kaislasuo Janina, Kopp-Kallner Helena, Cederblad Kristina, Heikinheimo Oskari, Gemzell-Danielsson Kristina, Hognert Helena, VEMA (Very Early Medication Abortion) Study Group
Аннотация
OBJECTIVE(S): To evaluate changes in serum/plasma human chorionic gonadotropin (hCG) from baseline levels in very early medication abortion (VEMA) in pregnancies of unknown location (PUL) and probable intrauterine pregnancy (IUP) to confirm treatment success.
STUDY DESIGN: A prospective cohort was selected from the VEMA randomized controlled trial conducted at 26 sites across nine countries. Patients with a gestational age ≤42 days without confirmed IUP on ultrasound (n = 741) received medication abortion according to WHO guidelines, hCG was measured at mifepristone intake and repeated on day 7 (+/-2). Changes in hCG were analyzed to distinguish the trends associated with complete abortion versus ectopic pregnancy, ongoing pregnancy, and incomplete abortion.
RESULTS: Among 533 cases with complete abortion, a decline in hCG level of ≥80% was observed in 96.8 of cases 7 (+/-2) days post-abortion. The mean hCG decline for complete abortions was 94% (CI: 93.2-94.9). None of the ectopic pregnancies 8 (1.7%) or ongoing pregnancies 21 (2.9%), showed a decline of ≥80%. Rising or insufficient decline (<80%) indicated ectopic and ongoing pregnancy. The hCG trend following complete abortion was significantly different from all other outcomes (p < 0.001), but trends did not distinguish between ectopic, ongoing pregnancy, or incomplete abortion.
CONCLUSION(S): A hCG decline of ≥80% within 7 (+/-2) days can effectively confirm complete abortion and rule out ectopic and ongoing pregnancies in early medication abortion. These results highlight the effectiveness of hCG monitoring as a reliable follow-up tool for managing VEMA without confirmed IUP.
IMPLICATIONS: This study highlights the value of hCG monitoring in early medication abortions in pregnancy of unknown location to differentiate between complete or incomplete abortion, ectopic, or ongoing pregnancy. An hCG decline of ≥80% within 7 (+/-2) days post-mifepristone can confirm complete abortion and help exclude ectopic and ongoing pregnancy.
STUDY DESIGN: A prospective cohort was selected from the VEMA randomized controlled trial conducted at 26 sites across nine countries. Patients with a gestational age ≤42 days without confirmed IUP on ultrasound (n = 741) received medication abortion according to WHO guidelines, hCG was measured at mifepristone intake and repeated on day 7 (+/-2). Changes in hCG were analyzed to distinguish the trends associated with complete abortion versus ectopic pregnancy, ongoing pregnancy, and incomplete abortion.
RESULTS: Among 533 cases with complete abortion, a decline in hCG level of ≥80% was observed in 96.8 of cases 7 (+/-2) days post-abortion. The mean hCG decline for complete abortions was 94% (CI: 93.2-94.9). None of the ectopic pregnancies 8 (1.7%) or ongoing pregnancies 21 (2.9%), showed a decline of ≥80%. Rising or insufficient decline (<80%) indicated ectopic and ongoing pregnancy. The hCG trend following complete abortion was significantly different from all other outcomes (p < 0.001), but trends did not distinguish between ectopic, ongoing pregnancy, or incomplete abortion.
CONCLUSION(S): A hCG decline of ≥80% within 7 (+/-2) days can effectively confirm complete abortion and rule out ectopic and ongoing pregnancies in early medication abortion. These results highlight the effectiveness of hCG monitoring as a reliable follow-up tool for managing VEMA without confirmed IUP.
IMPLICATIONS: This study highlights the value of hCG monitoring in early medication abortions in pregnancy of unknown location to differentiate between complete or incomplete abortion, ectopic, or ongoing pregnancy. An hCG decline of ≥80% within 7 (+/-2) days post-mifepristone can confirm complete abortion and help exclude ectopic and ongoing pregnancy.