Effect of transvaginal sonography on the use of invasive procedures for evaluating patients with a clinical diagnosis of ectopic pregnancy

Atri, Mostafa; Valenti, David; Bret, Patrice M.; Gillett, Peter

doi:10.1002/jcu.10131

Cited by 37 publications

(15 citation statements)

References 20 publications

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“…E-mail: ejkirk@hotmail.co.uk have an inconclusive scan and have an ectopic pregnancy diagnosed on a subsequent scan. [3][4][5][6][7][8] However, it must be remembered that most of these studies included follow-up scans or were performed immediately before surgery thus do not assess the ability to detect an ectopic pregnancy on a single TVS examination. They will then need follow-up to determine the final pregnancy outcomeintrauterine pregnancy, ectopic pregnancy, or failed pregnancy.…”

Section: Accuracy Of Ultrasound In the Diagnosis Of Ectopic Pregnancymentioning

confidence: 99%

Ultrasound in the Diagnosis of Ectopic Pregnancy

Kirk

2012

Clinical Obstetrics &Amp; Gynecology

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The majority of ectopic pregnancies can be diagnosed on transvaginal scan before treatment. Diagnosis should be based on positive visualization of an ectopic pregnancy rather the inability to visualize an intrauterine pregnancy. The majority of ectopic pregnancies will be visible on the initial transvaginal scan performed. Those who do not have their ectopic pregnancies visualized on the first examination will be initially classified as having a pregnancy of unknown location. They will then need follow-up until a diagnosis of ectopic pregnancy is confirmed. This review discusses the use of ultrasound in the diagnosis of ectopic pregnancy and the specific criteria for diagnosis of the different types of ectopic pregnancy.

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Section: Accuracy Of Ultrasound In the Diagnosis Of Ectopic Pregnancymentioning

confidence: 99%

Ultrasound in the Diagnosis of Ectopic Pregnancy

Kirk

2012

Clinical Obstetrics &Amp; Gynecology

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“…Ectopic pregnancies (EPs) are still the major contributor to first trimester maternal deaths, accounting for more than 80% of mortalities . Early diagnosis of EP can potentially prevent tubal rupture and haemorrhage, allowing effective management and avoidance of serious maternal morbidities …”

Section: Introductionmentioning

confidence: 99%

Is there a difference in the behaviour and subsequent management of ectopic pregnancies seen at first scan compared to those ectopic pregnancies which commence as pregnancies of unknown location?

Lattouf

Lü

Pixton

et al. 2016

Aust NZ J Obst Gynaeco

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“…Transvaginal ultrasonography in combination with serum β‐hCG is commonly used for the diagnosis of an EP. Transvaginal ultrasound is an important tool that can reliably predict the presence of ectopic pregnancy 14 . With transvaginal ultrasonography, viable intrauterine pregnancies should be visible with β‐hCG levels above 2000 IU/L.…”

Section: Discussionmentioning

confidence: 99%

Clinical utility of serum reproductive hormones for the early diagnosis of ectopic pregnancy in the first trimester

Feng

Chen

Zhang

et al. 2012

J of Obstet and Gynaecol

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Aim: A tubal ectopic pregnancy (EP) in the first trimester remains a major life-threatening complication for the mother. We aim to determine whether serum reproductive hormones may be clinically useful in the early identification of a tubal EP. Methods: A total of 109 age-matched patients with a serum b-human chorionic gonadotropin (b-hCG) concentration <2000 IU/L were enrolled, including 68 patients with a tubal EP, 22 with a viable intrauterine pregnancy (vIUP) and 19 with a non-viable intrauterine pregnancy (nIUP). Serum was collected during the first trimester of pregnancy and assayed for b-hCG, follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone (TE), progesterone (P), estradiol (E2) and prolactin (PRL) by using automated electrochemiluminescence immunoassays. Results: Patients with an EP had significantly lower levels of daily b-hCG variation (Db-hCG/day), P and E2, and significantly higher levels of LH and FSH than IUP patients (P < 0.05). As an EP diagnostic marker, progesterone demonstrated a sensitivity of 100% at the cutoff of 86.01 nmol/L. The combination of E2 with Db-hCG/day reached a specificity of 100% for EP evaluation. To identify non-viable pregnancies (including EPs and nIUPs), progesterone demonstrated a sensitivity of 95.40% and a specificity of 90.91% at the cutoff of 63.2 nmol/L; the diagnostic power of the receiver operating curve was 0.9702. Conclusions: A combination of Db-hCG/day, P and E2 may help distinguish EPs and nIUPs from vIUPs, facilitating earlier diagnosis and the timely implementation of medical treatment to prevent tubal rupture.

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Effect of transvaginal sonography on the use of invasive procedures for evaluating patients with a clinical diagnosis of ectopic pregnancy

Abstract: The introduction of TVS has had an important effect on the evaluation of patients with EP by nearly eliminating the need for D&C and DL and permitting clinicians to take a more conservative approach to managing EP.

Cited by 37 publications

References 20 publications

Ultrasound in the Diagnosis of Ectopic Pregnancy

Ultrasound in the Diagnosis of Ectopic Pregnancy

Is there a difference in the behaviour and subsequent management of ectopic pregnancies seen at first scan compared to those ectopic pregnancies which commence as pregnancies of unknown location?

Clinical utility of serum reproductive hormones for the early diagnosis of ectopic pregnancy in the first trimester

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