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Evaluation of maternal serum biomarkers in predicting outcome of successful expectant management of tubal ectopic pregnancies

Memtsa, M; Jauniaux, E; Gulbis, B; Jurkovic, D; (2020) Evaluation of maternal serum biomarkers in predicting outcome of successful expectant management of tubal ectopic pregnancies. European Journal of Obstetrics & Gynecology and Reproductive Biology , 250 pp. 61-65. 10.1016/j.ejogrb.2020.04.009. Green open access

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Abstract

OBJECTIVE: To assess the value of multiple serum biomarkers for the prediction of successful outcome of expectant management in women with tubal ectopic pregnancy (TEP). STUDY DESIGN: Women with a conclusive ultrasound diagnosis of TEP had a blood test to measure β-human chorionic gonadotropin (β-hCG), progesterone, inhibin A, activin A and high sensitivity C-reactive protein (hsCRP) at the initial visit. Women presenting with pain, serum β-hCG ≥ 1500 IU, evidence of a live ectopic pregnancy or a significant haemoperitoneum were advised to have emergency surgery. Women eligible for expectant management were followed-up prospectively until serum β-hCG declined to non-pregnant level or surgical treatment was required. RESULTS: A total of 93 women with a TEP were included in the final cohort. Emergency surgery was carried out in 42/93 (45 %) of women whilst 51/93 (55 %) were managed expectantly. Of the latter group, 42/51 (82 %) had successful expectant management and 9/51(18 %) required surgical procedure after a period of follow up. On multi-variable analysis, only higher values of serum β-hCG and progesterone at the initial visit were associated with a lower chance of successful expectant management of TEP. A one-unit increase in either variable on the log-scale was associated with an approximate 20-fold reduction in the odds of a successful outcome. CONCLUSION(S): Serum β-hCG and progesterone were significantly lower in women who had successful expectant management of TEP. Other biomarkers under consideration were not significantly different in women with successful and failed expectant management.

Type: Article
Title: Evaluation of maternal serum biomarkers in predicting outcome of successful expectant management of tubal ectopic pregnancies
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.ejogrb.2020.04.009
Publisher version: https://doi.org/10.1016/j.ejogrb.2020.04.009
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions.
Keywords: Early pregnancy complications, Tubal ectopic pregnancy, Ultrasound examination, Biomarkers, Reproductive endocrinology
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health > Reproductive Health
URI: https://discovery.ucl.ac.uk/id/eprint/10096681
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