Validation of a multiple marker test for early pregnancy outcome prediction

Liability, risks, and recommendations for ultrasound use in the diagnosis of obstetrics diseases

“…Ultrasound and serial hCG levels are recommended for monitoring. An ectopic pregnancy may be considered when hCG levels are excessively high but cannot be confirmed in isolation [ [35] , [36] , [37] , [38] ]. Due to the presence of discriminating levels, extreme caution is warranted when ruling out an intrauterine pregnancy with rising hCG.…”

Ectopic Pregnancy and Lifesaving Care

“…Although sensitivity and specificity in early pregnancy evaluation are improving, ultrasound may be inconclusive in up to 40% of patients at first evaluation . Serial trends in hCG, which are the standard of care to identify normal and abnormal early pregnancies prior to ultrasound confirmation, may misclassify up to 17% of ectopic pregnancies . Even if care is not delayed, life-threatening hemorrhage from rupture of the blood vessels and structure where the pregnancy has implanted can occur.…”

“…Up to 18% of pregnant individuals presenting to an emergency department with first trimester symptoms of bleeding, abdominal pain, or both (symptoms also common in a normal pregnancy) have an ectopic pregnancy. Although sensitivity and specificity in early pregnancy evaluation are improving, ultrasound may be inconclusive in up to 40% of patients at first evaluation . Serial trends in hCG, which are the standard of care to identify normal and abnormal early pregnancies prior to ultrasound confirmation, may misclassify up to 17% of ectopic pregnancies .…”