How low is hcg for ectopic pregnancy

Ectopic pregnancy is actually a relatively critical situation. If it occurs, it will cause great harm to the body of female friends. Therefore, when it happens, you must go to the hospital for relevant examinations as soon as possible. Only in this way can you determine whether you have this disease. Generally speaking, an hcg test is required. The results of this test can be used to determine whether you have an ectopic pregnancy and the specific severity of the pregnancy.

Clinical manifestations

1. Menopause

Except for pregnancy in the fallopian tube interstitial region, which lasts for a longer period of time, most cases last for 6 to 8 weeks. 20% to 30% of patients have no obvious history of amenorrhea, or their menstruation is only delayed by two or three days.

2. Vaginal bleeding

After the death of the embryo, there is often irregular vaginal bleeding, which is dark red in color and small in amount, generally not exceeding the amount of menstruation. A small number of patients have heavy vaginal bleeding, similar to menstruation, and may be accompanied by the discharge of decidual fragments.

3. Syncope and shock

Due to acute intra-abdominal bleeding and severe abdominal pain, mild cases may experience fainting, while severe cases may suffer from hemorrhagic shock. The more and faster the bleeding, the quicker and more severe the symptoms appear, but they are not proportional to the amount of vaginal bleeding.

examine

1. HCG determination

It is currently an important method for early diagnosis of ectopic pregnancy.

2. Progesterone determination

The serum P level in ectopic pregnancy is low, but it is relatively stable at 5 to 10 weeks of gestation, and a single measurement has a great diagnostic value. Although there is overlap between normal and abnormal pregnancy serum P levels, making it difficult to determine the absolute critical value between them, a serum P level lower than 10 ng/m1 (radioimmunoassay) often indicates abnormal pregnancy, with an accuracy rate of about 90%.

3. Ultrasound diagnosis

Type B ultrasound examination is particularly commonly used for the diagnosis of ectopic pregnancy, and vaginal ultrasound examination is more accurate than abdominal B-type examination.

4. Diagnostic curettage

When ectopic pregnancy cannot be ruled out, a diagnostic curettage can be performed to obtain the endometrium for pathological examination. However, the endometrial changes in ectopic pregnancy are not characteristic and may be manifested as decidual tissue, highly secretory phase with or without A-S reaction, and various secretory and proliferative phases. Changes in the endometrium are related to whether the patient has vaginal bleeding and the duration of vaginal bleeding. Therefore, the diagnosis of ectopic pregnancy based solely on diagnostic curettage has great limitations.

5. Posterior fornix puncture

Posterior uterine fornix puncture is widely used to assist in the diagnosis of ectopic pregnancy. Blood can often be drawn out and does not coagulate after being placed, and contains small blood clots. If no fluid is removed, the diagnosis of ectopic pregnancy cannot be ruled out.

6. Laparoscopy

In most cases, early ectopic pregnancy can be diagnosed after medical history, gynecological examination, blood β-HCG measurement, and B-ultrasound examination. However, for some cases that are more difficult to diagnose, examination under direct laparoscopy can provide a clear diagnosis in a timely manner and surgical treatment can be performed at the same time.

7. Other biochemical markers

It has been reported that the serum AFP level is elevated and the E2 level is low in patients with ectopic pregnancy. The combined measurement of the two with serum HCG and progesterone is superior to single measurement in the detection of ectopic pregnancy. In recent years, the detection of serum CA125 has been combined with β-HCG, and it has been found that the serum CA125 level tends to increase as the β-HCG level decreases. It can be used to identify whether an ectopic pregnancy has resulted in miscarriage or whether the embryo has died.