Success of early pregnancy loss treatment tied to higher fall in hCG levels: Study

USA: A new study conducted by Andrea H. Roe and team shows that treatment success following medical care for early pregnancy loss was related with a higher fall in human chorionic gonadotropin (hCG) concentrations than failure. The findings of this study were published in Obstetrics and Gynecology.

Medically, early pregnancy loss can be managed with mifepristone accompanied by misoprostol, with ultrasound confirmation of pregnancy expulsion. Alternative ways for remotely determining therapy success are required. As a result, the purpose of this study was to examine the percent drop in human chorionic gonadotropin (hCG) levels with therapy effectiveness or failure among patients.

Patients who took mifepristone pretreatment accompanied by misoprostol or misoprostol on its own for early pregnancy loss around 5 and 12 weeks of gestation were evaluated for this study in order to discover a threshold decrease that would indicate success.

The key findings of this study were as follow:

1. Treatment success for early pregnancy loss was related with a larger percent hCG level reduction compared to treatment failure, but no threshold could predict success.

2. The median hCG drop for participants who got mifepristone and misoprostol was 82.2% in those who received effective therapy and 66.9% in those who did not. The decrease was substantially larger in successful participants.

3. hCG fell by a median of 83.8% in patients who got misoprostol alone, and 47.6% in participants who failed therapy. Again, people who received effective therapy showed a considerably higher drop in hCG than those who did not.

4. Although the mifepristone/misoprostol combination was linked with a greater fall in hCG levels, using hCG to predict success and failure in this group was actually more difficult than in the misoprostol-only group.

5. To create acceptable methods for remote follow-up, further study is needed to characterize hCG patterns after medical care of early pregnancy loss.

In conclusion, miscarriage is a frequent and upsetting occurrence; increasing this and providing additional follow-up options would provide patients greater flexibility and privacy throughout this time.

Reference:

Roe, A. H., Abernathy, A., Flynn, A. N., McAllister, A., Koelper, N. C., Sammel, M. D., Schreiber, C. A., & Sonalkar, S. (2022). Utility and limitations of human chorionic gonadotropin levels for remote follow-up after medical management of early pregnancy loss. Obstetrics and Gynecology, 10.1097/AOG.0000000000004792. https://doi.org/10.1097/AOG.0000000000004792