Serum human chorionic gonadotropin and ultrasound criteria in women with successful expectant management of tubal ectopic pregnancies: a retrospective cohort study

ABSTRACT

Objective. To identify different variables associated with successful expectant management of tubal ectopic pregnancies.
Materials and Methods. A retrospective analysis was performed at a university hospital, examining the medical records of 88 cases of tubal ectopic pregnancy that were successfully managed through expectant management. Data regarding ultrasonographic criteria, peak serum β-hCG (human chorionic gonadotropin) levels, subsequent β-hCG trends during follow-up, and the duration (in days) required for resolution were analyzed.
Results. The mean diameter of the ectopic mass was 30.0 ± 9.73 mm and 26 ± 8.9 for the vertical and horizontal diameters, respectively. Twelve (18.5%) cases had no free fluid in the Douglas pouch. The median initial serum β-hCG concentration was 724.20 IU/L (IQR 361.95-1252.00, with the highest initial serum β-hCG concentration was 4617 IU/L.
The median time required for resolution was 15.0 days (IQR 12.0-18.0), whereas the median duration of hospitalization was 4.0 days (IQR 3-7.0).
Conclusions. Clinically stable women with tubal EP, ectopic mass up to 50 mm and those with variable degrees of hemoperitoneum and variable levels of β-HCG (up to 4617) can achieve successful expectant management. These findings provide valuable insights into identifying candidates suitable for expectant management in cases of tubal EP.