What should be performed 48-72 hours apart to assess viability in early pregnancy bleeding?

To effectively assess viability in early pregnancy bleeding, measuring serial serum β-HCG levels is critical. This method involves taking blood samples at intervals, specifically 48 to 72 hours apart, to track the levels of human chorionic gonadotropin (β-HCG).

In a normal early pregnancy, β-HCG levels should approximately double every 48-72 hours. If the levels are rising appropriately, this is a good indicator of a viable intrauterine pregnancy. Conversely, if the levels plateau or decrease, it may suggest a non-viable pregnancy, such as a missed miscarriage or an ectopic pregnancy.

While other methods, like transvaginal ultrasound, are also used in early pregnancy assessments, they typically provide information about the physical presence of a gestational sac or fetus but do not offer dynamic insights into the viability status over time as serial β-HCG measurements do. Monitoring fetal heart rate is not applicable in very early pregnancy, as it generally becomes detectable around six weeks gestation, making it unsuitable for assessing viability during initial bleeding stages. A complete blood count, while useful for evaluating anemia or infection, does not provide specific information regarding the viability of the pregnancy.

Thus, serial monitoring of serum β-HCG levels stands