Acta Medica Medianae
Vol. 50, No 3, September, 2011
UDK 61
ISSN 0365-4478(Printed version)
ISSN 1821-2794(Online)
 

Correspondence to:

Dragan Lončar

Gynecology and Obstetrics Clinic

Clinical Centre Kragujevac

Vojislava Kalanovića 1A/3

34000 Kragujevac, Serbia;

E-mail:drloncar@sezampro.rs

Original article                                                                                           

UDC: 618.31-073

doi:10.5633/amm.2011.0303

Evaluation of the importance of biochemical parameters in relation to ultrasonographic finding in ectopic pregnancy diagnosis

Dragan Lončar

Gynecology and Obstetrics Clinic, Clinical Center Kragujevac, Serbia

The implantation of the fertilized egg outside the uterine cavity leads to the development of ectopic pregnancy. The incidence of ectopic pregnancy is 1/100 births. The most common place of ectopic implantation of the fertilized ovum is the oviduct (98%) with predilection for the ampullar part of the Fallopian tube. The aim of this study was to determine the predictive importance of beta-hCG and progesterone concentration compared to ultrasonographic finding in the ectopic pregnancy diagnosis.

We examined 24 patients with ectopic pregnancies which we divided according to the days of amenorrhea into two groups: the first group with the total of 28 patients from 16–42 days and another group of 8 patients with amenorrhea longer than 42 days. The control group was comprised of 20 patients with vital intrauterine pregnancy, gestational age of 42-52 days. Blood samples for quantitative determination of hormones were collected on three occasions after 48 hours in the forenoon time in the examined and control group of pregnant women. Ultrasonographic examinations of all pregnant women were carried out immediately after blood sampling, with the trans-vaginal approach using "make loop" option, and measurements with an accuracy of 0.1 mm.

Mean values for beta-hCG range from 698-1774 mlU/ml in the first group of pregnant women, and in the second group of 1896 mlU/ml to 4410 mlU/ml with a statistically significant difference compared to the values in the control group (p <0.001). The concentration of progesterone in the first group of women ranging from 41-70 nmol/l, and in the second group of 76-94 nmol/l which is also the statistically significant difference compared to the control group (p<0.002). We have shown that ultrasonographic finding with its parameters reliably predicts the values of biochemical parameters both in normal intrauterine pregnancy and in the case of ectopic pregnancy.

Embryo viability and implantation place condition the values of biochemical parameters, which makes establishing the correct diagnose difficult by following only these markers. It is necessary to combine the growth dynamics of these hormones with ultrasonographic finding as the gold standard in diagnosing ectopic pregnancy. Acta Medica Medianae 2011;50(3):16-21.

      Key words: ectopic pregnancy, human chorionic gonadotropin, progesterone, ultrasonography