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
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.