Predictive Values Of The Ratio Of Beta-human Chorionic Gonadotropin For Failure Of Salpingostomy In Ectopic Pregnancy

Objective: We evaluate the predictors of unsuccessful salpingostomy that required surgical treatment or additional medical treatment after initial removal of the EP by laparoscopy.Methods: The study was an observational retrospective cohort study done at our hospital in Shanghai,which included patients with ectopic pregnancy(EP).The predictors of persistent ectopic pregnancy(PEP)were measured either on serum ?-hCG ratios before and after salpingostomy or demographics(age,parity,IVF,abortion history,EP history,mass location,appendectomy history and diameter of EP lesion).We used nomogram analyses to evaluated the significant factors consisting of serum ?-hCG ratio,parity and performed IVF that predicted the failure or success of salpingostomy.Results: We retrospectively analyzed 429 patients in this study who received salpingostomy for EP from January 2013 and December 2017.Of these patients,29(6.76%)were diagnosed with PEP after salpingostomy and 400(93.24%)had satisfactory treatment.The median of serum ?-hCG ratio(after salpingostomy 24h/after salpingostomy 48h)2.43 in PEP patients was lower than that in successful treatment patients(P<0.001).Logistic regression analyses identified several predictors for PEP,including parity,IVF and serum ?-hCG(after salpingostomy 24h/after salpingostomy 48h),with a higher clear predictive value(area under the curve [AUC]=0.865,95% CI: 0.812-0.919,P<0.001).Conclusions: The serum ?-hCG ratio(after salpingostomy 24h/after salpingostomy 48h)in combination with parity and IVF are important predictors for PEP patients after surgery.These findings provide higher risk PEP patients for early interventions to improve outcome.