Human chorionic gonadotropin ratio of hemoperitoneum versus venous serum improves early diagnosis of ectopic pregnancy.

OBJECTIVE

To analyze the value of the hCG ratio of peritoneal serum versus venous serum (R(P/V)) for early diagnosis and prognostic evaluation of ectopic pregnancy (EP).

DESIGN

Retrospective clinical study.

SETTING

University hospital.

PATIENT(S): One hundred three women with hemoperitoneum and positive urine hCG tests underwent laparoscopy or laparotomy.

INTERVENTION(S): Venous serum and peritoneal serum samples were obtained; ultrasound was performed in all the patients; dilatation and curettage was used in 28 patients.

MAIN OUTCOME MEASURE(S): Quantitative hCG and R(P/V).

RESULT(S): The R(P/V) in EP (5.55 +/- 4.32) is apparently greater than that in hemoperitoneum with intrauterine pregnancy (hIUP; 0.61 +/- 0.18). The median R(P/V) is 4.07 in the EP group versus 0.60 in the hIUP group, with a suggested threshold value of 1.0 for their differential diagnosis. Moreover, the R(P/V) of EP shows the dominant difference between the patients with active bleeding (8.03 +/- 3.29, n = 24) and the patients without active bleeding (4.59 +/- 3.88, n = 16) when the hCG level of venous serum is more than 1500 U/L.

CONCLUSION(S): R(P/V) could instantly diagnose ectopic pregnancy and differentiate it from hIUP.