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Can a single progesterone test distinguish viable and nonviable pregnancies accurately in women with pain or bleeding?

March 2013 · Vol. 25, No. 3
This week's quiz:
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Jaimey M. Pauli, MD, and John T. Repke, MD (Update, January 2013)

Evolving applications of first-trimester ultrasound
Ilan E. Timor-Tritsch, MD, and Simi K. Gupta, MD (December 2012)

Is the hCG discriminatory zone a reliable indicator of intrauterine or ectopic pregnancy?
Andrew M. Kaunitz, MD (Examining the Evidence, February 2012)

A few outliers don’t justify dismissing the hCG
discriminatory zone

(Comment & Controversy, April 2012)

It is not uncommon to see a patient in her first trimester who is experiencing abdominal pain or vaginal bleeding or both. At my institution, we use the beta human chorionic gonadotropin (ß-hCG) value in conjunction with transvaginal ultrasonography to determine whether the pregnancy is a viable intrauterine pregnancy, a missed spontaneous abortion, or an ectopic gestation. However, even a combination of modalities can be inconclusive, necessitating repeated ß-hCG measurements and several ultrasound images. For the patient, it can provoke considerable anxiety to be told to wait and see if the pregnancy will continue.

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