{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T23:55:32Z","timestamp":1792108532110,"version":"4.4.0"},"reference-count":26,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2005,11,25]],"date-time":"2005-11-25T00:00:00Z","timestamp":1132876800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2005,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Various serum human chorionic gonadotropin (hCG) discriminatory zones are currently used for evaluating the likelihood of an ectopic pregnancy in women classified as having a pregnancy of unknown location (PUL) following a transvaginal ultrasound examination. We evaluated the diagnostic accuracy of discriminatory zones for serum hCG levels of &gt; 1000 IU\/L, 1500 IU\/L and 2000 IU\/L for the detection of ectopic pregnancy in such women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective observational study of women who were assessed in a specialized transvaginal scanning unit. All women with a PUL had serum hCG measured at presentation. Expectant management of PULs was adopted. These women were followed up with transvaginal ultrasound, monitoring of serum hormone levels and laparoscopy until a final diagnosis was established: a failing PUL, an intrauterine pregnancy (IUP), an ectopic pregnancy or a persisting PUL. The persisting PULs probably represented ectopic pregnancies which had been missed on ultrasound and these were incorporated into the ectopic pregnancy group. Three different discriminatory zones (1000 IU\/L, 1500 IU\/L and 2000 IU\/L) were evaluated for predicting ectopic pregnancy in this PUL population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 5544 consecutive women presented to the early pregnancy unit between 25 June 2001 and 14 April 2003. Of these, 569 (10.3%) women were classified as having a PUL, 42 of which were lost to follow up. Of the 527 (9.5%) cases with PUL analyzed, there were 300 (56.9%) failing PULs, 181 (34.3%) IUPs and 46 (8.7%) ectopic pregnancies. Overall, 74.6% were symptomatic and 25.4% were asymptomatic (<jats:italic>P<\/jats:italic> = 8.825<jats:italic>E<\/jats:italic>\u201307). The sensitivity and specificity of an hCG level of &gt; 1000 IU\/L to detect ectopic pregnancy were 21.7% (10\/46) and 87.3% (420\/481), respectively; for an hCG level of &gt; 1500 IU\/L these values were 15.2% (7\/46) and 93.4% (449\/481), respectively, and for an hCG level of &gt; 2000 IU\/L they were 10.9% (5\/46) and 95.2% (458\/481), respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Varying the discriminatory zone does not significantly improve the detection of ectopic pregnancy in a PUL population. A single measurement of serum hCG is not only potentially falsely reassuring but also unhelpful in excluding the presence of an ectopic pregnancy. Copyright \u00a9 2005 ISUOG. Published by John Wiley &amp; Sons, Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.2636","type":"journal-article","created":{"date-parts":[[2005,11,25]],"date-time":"2005-11-25T12:17:15Z","timestamp":1132921035000},"page":"770-775","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":132,"title":["Diagnostic accuracy of varying discriminatory zones for the prediction of ectopic pregnancy in women with a pregnancy of unknown location"],"prefix":"10.1002","volume":"26","author":[{"given":"G.","family":"Condous","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Kirk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Van Huffel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O.","family":"Gevaert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"De Moor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"De Smet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Timmerman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Bourne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2005,11,25]]},"reference":[{"key":"e_1_2_5_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.humrep.a138247"},{"key":"e_1_2_5_3_2","first-page":"156","article-title":"Discriminatory hCG zone: its use in the sonographic evaluation for ectopic pregnancy","volume":"58","author":"Kadar N","year":"1981","journal-title":"Obstet Gynecol"},{"key":"e_1_2_5_4_2","first-page":"162","article-title":"A method of screening for ectopic pregnancy and its indications","volume":"58","author":"Kadar N","year":"1981","journal-title":"Obstet Gynecol"},{"key":"e_1_2_5_5_2","first-page":"357","article-title":"Diagnosis of ectopic pregnancy: value of the discriminatory human chorionic gonadotropin zone","volume":"66","author":"Romero R","year":"1985","journal-title":"Obstet Gynecol"},{"key":"e_1_2_5_6_2","first-page":"770","article-title":"Comparison of abdominal and vaginal sonography in suspected ectopic pregnancy","volume":"73","author":"Cacciatore B","year":"1989","journal-title":"Obstet Gynecol"},{"key":"e_1_2_5_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1990.tb02445.x"},{"key":"e_1_2_5_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-199910000-00018"},{"key":"e_1_2_5_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(98)00278-7"},{"key":"e_1_2_5_10_2","first-page":"594","article-title":"Role of transvaginal ultrasonography in the diagnosis of ectopic pregnancy","volume":"70","author":"Mol B","year":"1998","journal-title":"Fertil Steril"},{"key":"e_1_2_5_11_2","first-page":"724","article-title":"Management of suspected ectopic pregnancy: impact of new diagnostic tools in 686 consecutive cases","volume":"41","author":"Ankum W","year":"1996","journal-title":"J Reprod Med"},{"key":"e_1_2_5_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.humrep.a136123"},{"key":"e_1_2_5_13_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.1999.14040231.x"},{"key":"e_1_2_5_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2004.04.004"},{"key":"e_1_2_5_15_2","first-page":"258","article-title":"Suspected ectopic pregnancy: expectant management in patients with negative sonographic findings and low serum hCG concentrations","volume":"1","author":"Hajenius PJ","year":"1995","journal-title":"Early Pregnancy"},{"key":"e_1_2_5_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.humrep.a138246"},{"key":"e_1_2_5_17_2","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deh746"},{"key":"e_1_2_5_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2003.09.011"},{"key":"e_1_2_5_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2004.00542.x"},{"key":"e_1_2_5_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deh770"},{"key":"e_1_2_5_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(97)00425-1"},{"key":"e_1_2_5_22_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2001.00031.x"},{"key":"e_1_2_5_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(16)56749-1"},{"key":"e_1_2_5_24_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.205.2.9356647"},{"key":"e_1_2_5_25_2","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deh341"},{"key":"e_1_2_5_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(99)00328-3"},{"key":"e_1_2_5_27_2","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/14.11.2855"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fuog.2636","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fuog.2636","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.2636","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,7]],"date-time":"2023-10-07T09:36:21Z","timestamp":1696671381000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.2636"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2005,11,25]]},"references-count":26,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2005,12]]}},"alternative-id":["10.1002\/uog.2636"],"URL":"https:\/\/doi.org\/10.1002\/uog.2636","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2005,11,25]]},"assertion":[{"value":"2005-06-22","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2005-11-25","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}