Ectopic Pregnancy: Vascularity Index as a Novel Diagnostic Criterion

Abstract

Background and aims:To determine the value of using Three-Dimensional Ultrasound with Power Doppler Angiography for the diagnosis and management of Ectopic Pregnancy.Methods: Three-dimensional ultrasound was used at the time of presentation to the Emergency Department of a facility for patients who were ultimately diagnosed with having a tubal Ectopic Pregnancy. This prospective observational investigation compared the results of offline analysis with outcomes after treatment (e.g. tubal rupture), suggesting its potential for predicting that outcome. Results:Of the 64 consecutive confirmed cases of Ectopic Pregnancy presenting to the Emergency Department of a single hospital, 39 patients were intact and 26 of them were medically treated with methotrexate. There were 9 subsequent failures of this treatment, resulting in 8 ruptures and one case with a continued rise of human Chorionic Gonadotropin. The Power Doppler Angiography quantification of the Vascularity Index correlated with those failed outcomes. STARD standards were applied to this investigation.Conclusions: Use of Three-Dimensional Ultrasound with Power Doppler Angiography with measurement of the Vascularity Index for patients presenting with an Ectopic Pregnancy may have value for determining which patients are best treated with surgical intervention rather than the use of medical treatment.