Predictive value of maternal serum beta-hCG concentration in the ruptured tubal ectopic pregnancy

Measurement of serum beta-hCG concentration commonly used to diagnose tubal ectopic pregnancy [EP] and follow up patients treated conservatively. The aim of this study was to determine the predictive value of maternal serum beta-hCG concentration in ruptured tubal ectopic pregnancy to help physicians identify those women who are at greatest risk. This is a cross-sectional study conducted on all women with a diagnosis of tubal ectopic pregnancy who were treated in Alzahra Hospital, in Rasht, from March 2002 to February 2011. The data was collected for each woman from medical records and included age, parity, gravidia, gestational age, primary level of serum beta-hCG, rupture status, past history of pelvic inflammation disease, EP, abortion, and intrauterine contraceptive device use. Women with tubal rupture were compared to those without rupture. Statistical analysis was conducted by SPSS 19 for Windows. A total of 247 cases of tubal ectopic pregnancy were recorded during the study period. One hundred and ninety seven [79.8%] were cases with unruptured EP and 50 patients [20.2%] were cases with ruptured EP. The mean level of beta-hCG was significantly higher in patients with ruptured EP compared to patients with unruptured EP [p=0.03]. Logistic regression analysis revealed that >1750 IU/ml of beta-hCG levels [OR: 1.41; 95% CI: 1.18-1.68] was the significant risk factors for tubal rupture. Higher beta-hCG levels seem to be significant risk factors for rupture of a tubal EP

relationship between vaginal bleeding in the first and second trimester of pregnancy and preterm labor

Vaginal bleeding is a common complication during pregnancy, which is observed in about 1/4 of pregnancies and in half of cases can lead to abortion. If vaginal bleeding happens during pregnancy some adverse pregnancy outcomes, including perinatal mortality and morbidity, low birth weight and preterm delivery will be increased. The aim of this study was to determine the relationship between vaginal bleeding and its characteristics in the first and second trimester of pregnancy and preterm labor. This is a case-control study conducted on 440 pregnant women referred to Al-Zahra Hospital in Rasht, Iran. Data were collected by a form. The form included demographic characteristics and confounding factors, the occurrence of bleeding during pregnancy and its features. Data were analyzed by T test, chi square and logistic regression in SPSS 16. Findings showed that vaginal bleeding was associated with 3 times increased risk of preterm delivery [OR: 3, 1.84-4.89]. Also, findings showed that bleeding characteristics including bleeding time, frequency, severity and intensity was significantly associated with preterm labor. According to significant association between vaginal bleeding and preterm delivery, it seems that performing some interventions to prevent preterm labor could be appropriate.