Predictive value of serum ß-hCG for early pregnancy outcomes among women with recurrent spontaneous abortion.

International journal of gynaecology and obstetrics : the official organ of the International Federation of Gynaecology and Obstetrics

PubMedID: 27567433

Liu Y, Liu Y, Li X, Jiao X, Zhang R, Zhang J. Predictive value of serum ß-hCG for early pregnancy outcomes among women with recurrent spontaneous abortion. Int J Gynaecol Obstet. 2016;.
OBJECTIVE
To examine peak serum levels of the ß-subunit of human chorionic gonadotropin (ß-hCG) for prediction of early pregnancy outcomes among women with recurrent spontaneous abortion (RSA).

METHODS
In a retrospective study, the medical records of pregnant women with a history of RSA treated at Sun Yat-sen Memorial Hospital, China, between January 2011 and July 2013 were reviewed. Serum ß-hCG had been measured twice weekly from 5 to 13weeks of pregnancy, and pregnancy was monitored by transvaginal ultrasonography to 13(+6)weeks. Optimal cutoff for peak ß-hCG level was determined by receiver operator characteristic curve analysis and Youden index. Women were divided into four groups on the basis of optimal peak ß-hCG cutoff and pregnancy outcome (pregnancy at 13weeks or spontaneous abortion). Peak ß-hCG levels and length of pregnancy at this peak were examined.

RESULTS
Overall, 1240 patients were included. The optimal cutoff value of peak ß-hCG was 88 468IU/L, with a sensitivity, specificity, positive predictive value, and negative predictive value for successful pregnancy of 95.6%, 88.0%, 95.6%, and 89.0%, respectively. A faster rise in ß-hCG, higher peak ß-hCG, and longer pregnancy length at peak ß-hCG were associated with successful early pregnancy.

CONCLUSION
A cutoff value of serum ß-hCG of 88 000IU/L could be used to predict early pregnancy outcomes for women with a history of RSA.