Relation of serum Beta HCG with gestational sac diameter -possibility of ectopic

a) SERUM Beta HCG:--Points in favour of Beta HCG. This is detectable in only when the serum conc. / titer is > 5 mIU//ml. It `will be detected `in urine only when the serum conc is >20-25 mIU/mL.-hCG comes from synncytito-trophoblasts from day 5-day 8 of fertilization. Doubling tome of β-hCG is about a) before 7 weeks of gestation 1.5 days b) after 7 weeks i.e. from day 49 of LMP= 3.5 days.

b) Interpretations of serum β-hCG?

1) Poor rise of beta HCG:- Abnormal rise may be due to Failing IUP.

2) 30% of all tubal ectopic show normal rise pattern. By contrast only, 70% rise will be slow rise. As such, abnormal beta HCG levels are only suspicious and are not diagnostic.

3) Therefore EP can have normal, rising or falling plateau. Β-hCG can be 1 below the expected value 2) Delay in rise –slow rise depending on the functional integrity of syncytio trophoblast. Or 3) Plateau is maintained for couple of days,. 4) Fall of beta HCG.

c)  How relevant is estimation of serum progesterone?? Serum Progesterone:-Progesterone Value= if< 9.4 ng then think of EP. Progesterone Value= if< 9.4 ng then think of EP.

RELATIONSHIP WITH Beta HCG & GSD/MSD=

6mm	1,226
9 mm.	2,085
12 mm	3,502
16 mm	6,776.
18 mm	9,343
21 mm	15,020,
23 mm	17,560.