Do you need to follow hCG (human chorionic gonadotropin) levels to zero for everyone who has had a spontaneous abortion?

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Evidence-Based Answer

Probably not. Rapidly declining hCG levels noted in the first 2–7 days after a patient presents with symptoms of miscarriage have a 95% probability of indicating a completed spontaneous abortion. For clinical application, the higher the initial hCG level, the greater the percentage decrease in hCG is needed. A very small percentage (0.7%) of patients with declining hCG levels will have an ectopic pregnancy (SOR: B, limited prospective, retrospective cohort, and cross-sectional studies).

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