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Chemical Pathology

Notes

Beta-human chorionic gonadotrophin (BHCG) levels are used in the management of patients with suspected ectopic pregnancy or pregnancy of unknown location (PUL).

Patients must be haemodynamically stable, have a positive urine pregnancy test (urine testing available in Microbiology Department), but show no sign of uterine pregnancy on transvaginal ultrasound scan.

HCG levels are also used in the follow-up of patients with ectopic pregnancy who have been treated with methotrexate.

Sample requirements

If patient on high dose biotin therapy (>5mg/day) collect sample at least 8 hours after the last dose

Requests for beta-HCG always require a fresh sample. The test cannot be added to a sample already in the laboratory because of the risk of carryover

For adults, blood taken into a 5mL gold top tube (or rust top for the Acute Unit)

5ml gold tube






Storage/transport

Do not store. Send at ambient temperature to the laboratory.

Required information

Relevant clinical details including urine pregnancy test result, TVS scan result, date and time of sample, any methotexate treatment.

Turnaround times

The assays are run throughout the day and night. Results are normally available within 24 hours. The test can be ordered as an urgent request.

Reference ranges

Serum hCG levels in healthy women:

Non-pregnant premenopausal women: 97.5% of women have results ≤ 1 iU/L

Postmenopausal women: 97.5% of women have results ≤ 7 iU/L

Acute unit staff: please refer to Trust Policy (Reference A0238) for interpretation of Beta-HCG levels in investigation and management of ectopic pregnancy.

Further information

RCOG Guidelines 21: The Management of Tubal Pregnancy

Lab Tests Online: hCG Test

Analyte Monograph alongside the National Laboratory Medicine Handbook


Page last updated 05/06/2018