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Methods defining high and low risk of ectopic in PUL
M4 model
Progesteron
hCG
Several hCG measurements/ logarithmic function
= good discriminator between vital and non‐viable pregnancy: ≤10nmol/l suggestive for failing pregnancy
Several hCG levels
1/48 ectopic in low risk
1/21 ectopic in low risk
1/23 ectopic in low risk
‐> M6 (prog and hCG)
Plus: just 1 blood sample: if initial prog<2nmol/l: 1/6 women just one hCG urin sample after 2weeks
Guha S, Ayim F, Ludlow J, Sayasneh A, Condous G, Kirk E, Stalder C, Timmerman D, Bourne T, Van Calster B. Triaging pregnancies of unknown location: the performance of protocols based on single serum progesterone or repeated serum hCG levels. Human Reproduction, 2014, Vol 29, 938‐945.
Protocol PUL
TVS diagnosis PUL Progesterone and hCG
Model M6
If Prog > 2nmol/L, then hCG after 48h
Defining high or low risk with prediction model M6
Progesterone 1 nmol/L = 1 μg/L x 3,18
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