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Gynaecology & Obstetrics General ed6a0ff3

True statement regarding ectopic pregnancy:a) Pregnancy test positiveb) hCG levels should be >1000 mlU/ml for earliest detection of gestational sac by TVSc) hCG levels should be <1000 mlU/ml for earliest detection of gestational sac by TVSd) Methotrexate is used

A
abd
B
bcd
C
abc
D
ab
High-Yield Explanation
Lets see each option separately- Option a- “Urine pregnancy test - ELISA is sensitive to 10-50 MIU/ml and are positive in 95% of ectopic pregnancies.” Dutta Obs. 7/e, p 182 “Current serum and urine pregnancy test that use enzyme - linked immunosorbent assays (ELISA) for -hcG are sensitive of levels of 10 to 20 MIU/ml and are positive in greater than 99% of ectopic pregnancies.” Williams Obs. 23/e, p 242, Thus option ‘a’ is correct. “The lowest level of serum hCG at which a gestation sac is consistently visible using TVS (discriminatory zone) is 1500 IU/L. the corresponding value of serum hCG for TAS is 6000 IU/L. When the hCG value is greater than 1500 IU/L and there is an empty uterine cavity, ectopic pregnancy is more likely”. Ref Dutta Obs. 7/e, p 183 “A number of investigation have described discriminatory hCG levels above which failure to visualize a uterine pregnancy indicates with high reliability that pregnancy is not alive or ectopic. Banhart and colleagues (1994) reported that an empty uterus with serum hCG concentration 1500 MIU/ml was 100% accurate in excluding a live pregnancy.'" Williams Obs. 23/e, p 244 Thus option ‘b’ is correct and option ‘c’ incorrect.

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