Early pregnancy assessment

HCG (cont.)
If there are no clinically suspicious features, it is usual practice to wait 48 hours and repeat the ultrasound and HCG level. In a small number of women, they may require more time for diagnosis to become clear.

Treatment
If the HCG level is <1000 i.u., or falling rapidly, the patient is usually managed conservatively. It is imperative that such patients are followed up every 48 hours, as it is not unusual for the HCG level to rise quickly to levels associated with tubal rupture. Occasionally in these cases, other treatments such as Methotrexate or Mifepristone may help.

Fortunately, rapid access to early pregnancy assessment means that very few women die as a result of this condition: worldwide it remains a significant cause of maternal mortality.

See next page for 'Early Pregnancy Problems'