4.6 Article

Utility and Limitations of Human Chorionic Gonadotropin Levels for Remote Follow-up After Medical Management of Early Pregnancy Loss

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OBSTETRICS AND GYNECOLOGY
卷 139, 期 6, 页码 1149-1151

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LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/AOG.0000000000004792

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  1. Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health [R01-HD0719-20, K12-HD001265-20]
  2. National Institutes of Health [R01-HD0719-20]

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This study compared different treatments for early pregnancy loss and found that treatment success was associated with a greater decline in hCG levels, but no threshold could predict success. Further research is needed to develop reliable remote follow-up protocols for early pregnancy loss.
Early pregnancy loss can be treated medically with mifepristone followed by misoprostol, with ultrasonographic confirmation of pregnancy expulsion. Alternative strategies that ascertain treatment success remotely are needed. We compared percent decline in human chorionic gonadotropin (hCG) level with treatment success or failure between patients who received mifepristone pretreatment followed by misoprostol or misoprostol alone for early pregnancy loss between 5 and 12 weeks of gestation to determine a threshold decline that might predict success. Early pregnancy loss treatment success was associated with a greater percent hCG level decline compared with treatment failure, but no threshold was able to predict success. Additional research is needed to understand hCG trends after medical management of early pregnancy loss to develop reliable protocols for remote follow-up.

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