How much hcg will cause the embryo to die in ectopic pregnancy

When a woman becomes pregnant, her body's hormones change, and hCG is one of the hormones that changes very obviously. At the same time, hcg is also an important basis for promoting the maturation of the placenta in the body, so if the hcg is too low, it will also affect the maturity of the placenta. For women with certain special physical conditions, ectopic pregnancy is prone to occur after pregnancy. So, at what hcg level will the embryo die in an ectopic pregnancy?

The main function of Hcg is to stimulate the corpus luteum, which is beneficial to the continuous secretion of estrogen and progesterone, so as to promote the formation of uterine decidua and make the placenta grow and mature. When a woman becomes pregnant, if the amount of HCG is large and the daily titer continues to rise rapidly, rising by more than 66% every 48 hours, it can be diagnosed as an intrauterine pregnancy. If the increase is less than 66%, there is a high possibility of ectopic pregnancy or intrauterine pregnancy hypoplasia.

For example, if today's hcg value is 234, if it is around 450 the day after tomorrow, it can be considered as normal intrauterine pregnancy. For example, if the HCG value is 10 today, 15 the day after tomorrow, and 17 two days later, then this HCG value is definitely abnormal. A slow increase for two consecutive times indicates an ectopic pregnancy or abnormal developmental delay of the embryo.

If the HCG value continues to drop significantly, it is best to perform a uterine curettage even if the fetal heart rate is detected by B-ultrasound, because the fetus is actually brain dead. If the HCG increases very quickly, it indicates the possibility of hydatidiform mole, which must be closely monitored. Of course, it may also be twins.

How much hcg will cause the embryo to die in ectopic pregnancy

Under normal circumstances, if the HCG value gradually increases, it indicates an ectopic pregnancy. If it is conservative treatment with medication, the embryo will definitely not be killed, so it will definitely not work. If HCG gradually decreases and the mass outside the uterus gradually decreases, then there is no big problem. Just remember that HCG is gradually decreasing. Only when it reaches normal level can it mean there is no problem and the alarm can be lifted. If HCG is not fixed, the embryo will die. As long as HCG is gradually decreasing, it means that conservative treatment of ectopic pregnancy is effective. Under normal circumstances, if conservative treatment fails, surgical removal of the diseased tissue can also be considered. Therefore, during the conservative treatment of ectopic pregnancy, HCG gradually decreases until it returns to normal, indicating that the conservative treatment of ectopic pregnancy is successful. Otherwise, the temperature may drop and then rise at any time, and ectopic pregnancy may rupture at any time.

Other methods of diagnosing ectopic pregnancy

1. Vaginal Ultrasound

The positive predictive value of using a normal increase in hCG to exclude ectopic pregnancy is approximately 95%. Comparing ultrasound results and hcg concentration can also estimate ectopic pregnancy. When hcg reaches 1000UL, vaginal ultrasound should be able to identify the intrauterine gestational sac. When hcg must reach 6500UL, abdominal ultrasound can identify the intrauterine gestational sac. If not, ectopic pregnancy should be suspected.

2. Blood progesterone value

If HCG is difficult to confirm, blood progesterone can be used for auxiliary diagnosis. All patients with ectopic pregnancy have low blood progesterone levels, so it can be used as one of the early diagnosis methods. In ectopic pregnancy, serum progesterone levels are low, mostly between 10-25ng/ml. If the serum progesterone value is >25ng/ml, the chance of ectopic pregnancy is less than 1.5%. If its value is <5ng/ml, intrauterine pregnancy abortion or ectopic pregnancy should be considered.

3. Laparoscopy

Laparoscopy is the gold standard for the diagnosis of ectopic pregnancy, and laparoscopic surgery can be performed at the same time as the diagnosis is confirmed. However, approximately 3%-4% of patients are missed due to a small gestational sac, or may be misdiagnosed as ectopic pregnancy due to fallopian tube dilation and color change, so attention should be paid.

4. Posterior vaginal fornix puncture

This approach is suitable for patients suspected of intra-abdominal bleeding. Intra-abdominal bleeding is most likely to accumulate in the rectouterine pouch. Even if the amount of bleeding is not large, blood can be drawn out through puncture of the posterior vaginal fornix. In the case of old ectopic pregnancy, small pieces of old blood or non-coagulated blood may be drawn out. When there is no internal bleeding, the amount of internal bleeding is very small, the hematoma is located higher, or there is adhesion in the rectouterine pouch, blood may not be able to be drawn out. Therefore, a negative posterior vaginal fornix puncture cannot rule out tubal pregnancy.