Archives of Gynecology and Obstetrics

, Volume 287, Issue 2, pp 323–328

Could serum β-hCG levels and gestational age be the indicative factors for the prediction of the degree of trophoblastic invasion into tubal wall in unruptured ampullary pregnancies?

  • Emre Niyazi Turgut
  • Ebru Celik
  • Serdar Celik
  • Deniz Cemgil Arikan
  • Huseyin Altuntas
  • Cem Leblebici
  • Sevim Purisa
  • Ramazan Dansuk
General Gynecology

DOI: 10.1007/s00404-012-2566-1

Cite this article as:
Turgut, E.N., Celik, E., Celik, S. et al. Arch Gynecol Obstet (2013) 287: 323. doi:10.1007/s00404-012-2566-1

Abstract

Objective

To evaluate the predictive value of gestational age and maternal serum β-hCG concentration for the determination of the depth of trophoblastic invasion into the tubal wall.

Methods

This is a retrospective trial conducted on women with a diagnosis of ampullary pregnancy (71) who were submitted to salpingectomy. Serum β-hCG measurements were obtained at the initial admission of hospital. Histological investigation was performed by a single well-experienced pathologist who was blind to the clinical and laboratory characteristics of the patients. Ampullary pregnancy was classified histologically according to the depth of trophoblastic infiltration into tubal wall: trophoblast limited to the tubal mucosa (stage I), extended to muscularis layer (stage II) and complete tubal wall infiltration up to serosal layer (stage III).

Results

There was a significant difference in maternal serum β-hCG concentrations regarding the histological stages of trophoblastic invasion. The serum β-hCG concentrations that the best predicted for stage III trophoblastic invasion was 6,475 mIU/ml, with a sensitivity of 100 %, a specificity of 92 %.

Conclusion

The depth of trophoblastic tissue infiltration into tubal wall is correlated with serum β-hCG levels, but not with gestational age. These findings may explain the reason for conservative management failure of EP in women with high β-hCG concentrations.

Keywords

Serum β-hCG Ampullary pregnancy Trophoblastic infiltration Gestational age 

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Emre Niyazi Turgut
    • 1
  • Ebru Celik
    • 1
  • Serdar Celik
    • 1
  • Deniz Cemgil Arikan
    • 2
  • Huseyin Altuntas
    • 1
  • Cem Leblebici
    • 3
  • Sevim Purisa
    • 4
  • Ramazan Dansuk
    • 1
  1. 1.Department of Obstetrics and GynecologyIstanbul Education and Research HospitalFatih, IstanbulTurkey
  2. 2.Medical Faculty, Department of Obstetrics and GynecologyKahramanmaras Sutcuimam UniversityKahramanmarasTurkey
  3. 3.Department of PathologyIstanbul Education and Research HospitalIstanbulTurkey
  4. 4.Department of Biostatistics, Istanbul Medical FacultyUniversity of IstanbulIstanbulTurkey

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