The introduction of a serum β-hCG threshold for suspected ectopic pregnancy, in a district general hospital, is safe and cost effective

Summary

We assessed the effect of introducing a rapid, serum /?-hCG assay as part of a routine ‘early pregnancy assessment’ service in a District General Hospital on treatment costs and the negative laparoscopy rate.

Eighty-five consecutive women presenting who had an empty uterus on transvaginal scan and a positive urinary pregnancy test had a serum β-hCG measured. They were managed according to a simple algorithm. Laparoscopy was performed when a serum β-hCG was above a threshold level of 1000 iu/1.

he algorithm had a sensitivity of 100 per cent and the negative laparoscopy rate was reduced from 61 to 9 per cent. There were no false negative diagnoses and no emergency admissions in those patients discharged home.

This simple addition to an already established early pregnancy assessment service, in our unselected population, has provided a safe and cost effective method which can reduce unnecessary admissions and operative morbidity in the management of suspected ectopic pregnancy.