Serum ß-HCG Level in Women Diagnosed as Having Retained Products Of Conception: A Prospective Cohort Study.
J Minim Invasive Gynecol
; 29(3): 424-428, 2022 03.
Article
em En
| MEDLINE
| ID: mdl-34801711
ABSTRACT
STUDY OBJECTIVE:
Retained products of conception (RPOC) may occur after delivery or abortion, often necessitating operative hysteroscopy for their removal. A preoperative diagnosis of RPOC by ultrasonography is not always accurate and may lead to unnecessary surgical procedures. We sought to evaluate whether serum level of ß-human chorionic gonadotropin (ß-HCG) may aid in the preoperative diagnosis of RPOC.DESIGN:
A prospective cohort study.SETTING:
Gynecology department in a university affiliated medical center. PATIENTS Women undergoing operative hysteroscopy for removal of RPOC between December 2019 and January 2021.INTERVENTIONS:
Operative hysteroscopy for RPOC removal. Serum ß-HCG levels were obtained on the day of surgery, and level ≥5.0 mIU/mL was considered positive. All operative specimens were evaluated by pathology for the presence of trophoblastic tissue. MEASUREMENTS AND MAINRESULTS:
Of the 105 women recruited to the study, the operative pathology showed trophoblastic tissue in 81 cases (77.1%), and they were included in the data analysis. The ß-HCG level was positive in 16 of those 81 cases (19.8%). Positive ß-HCG level was significantly associated with RPOC after an abortion (surgical or medical) compared with RPOC after delivery. In addition, the mean RPOC mass was larger in the ß-HCG-positive group than the ß-HCG-negative group (29.1 ± 9.5 mm vs 23.8 ± 8.9 mm, respectively, p = .004), and the interval from termination of pregnancy to surgery was shorter (4.8 ± 1.7 weeks vs 7.5 ± 2.1 weeks, respectively, p <.001). Relatively high ß-HCG level (352 mIU/mL and 3561 mIU/mL) were found in 2 cases in which the RPOC mass was implanted on a previous cesarean section scar.CONCLUSION:
ß-HCG level is noncontributory to the preoperative diagnosis of RPOC.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
Base de dados:
MEDLINE
Assunto principal:
Cesárea
/
Placenta Retida
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
/
Pregnancy
Idioma:
En
Revista:
J Minim Invasive Gynecol
Assunto da revista:
GINECOLOGIA
Ano de publicação:
2022
Tipo de documento:
Article