P27.06: Prediction of ectopic pregnancy with transvaginal Doppler ultrasonography based on multivariate logistic model

Abstract

Objectives: This study established a regression model with the relative factors, evaluated its clinical applied value, and explored the diagnostic criterias of transvaginal Doppler ultrasonography (TDU) in predicting early ectopic pregnancy (EP). Methods: The thickness, symmetry, resonance, pattern, blood flow display of endometrial and artery RI value etc were analyzed and observed by TDU. The significant diadynamic criterias with multivariate Logistic regression analysis were selected in order to establish the multivariate predictive model for early EP diagnosis. Results: The multivariate analysis indicated that the final predictive model included three factors as follow: whether the endometrial thickness was more than 9 mm, whether the endometrial pattern was type A, and whether the endometrial spiral arteriae were detected by TDU. The area under the ROC curve of the TDU multivariate predictive model was 0.980. The coincidence rate was 94.5%, when this model was used to diagnose early EP. Conclusions:We conclude that the multivariate regressive predictive model established in this study has significant clinical value in the differential diagnosis of early EP. Objectives: The aim was to determine variables that are associated with a higher risk of miscarriage in the 1 st trimester in women with an intrauterine pregnancy of uncertain viability (IPUVI). Methods: Prospective observational study. Women in the 1 st trimester of pregnancy presenting to the Early Pregnancy Unit (EPU), between Nov 2006 and Dec 2010, underwent a transvaginal scan (TVS). Data was collected from women with an IPUVI at the first ultrasound (US). More than 40 historical, clinical and US end points were recorded for analysis. US measurements included gestational sac (GS) and yolk sac (YS) in three planes, crown-rump length (CRL) and fetal heart rate (FHR). Women were followed up until the outcome was established: viable or non-viable IUP at the end of the 1 st trimester. Univariate analysis to study the effect of the variables on the first trimester outcome was performed using ANOVA F-test and Fisher's exact test. Results: 346 pregnancies were included. 45.7% (158/346) were viable at the end of the 1 st trimester, 41.6% (144/346) were nonviable and 10.4% (36/346) did not have 1 st trimester outcomes available. The continuous variables that were significantly associated with a higher rate of miscarriage were: higher maternal age (mean maternal age for viable pregnancies 26.9 yrs vs. mean maternal age for miscarriages 30.7 yrs, P value = 3.33E-05), higher gestational age (GA) in days by LMP (mean GA for viable pregnancies 41.9 days vs. mean GA for miscarriages 52.7 days, P value = 1.78E-12), and higher CRL (mean CRL for viable pregnancies 0.22 mm vs. mean CRL for miscarriages 0.95 mm, P = 1.91E-05). The categorical variables that were associated with a higher rate of miscarriage were: previous miscarriage, history of vaginal bleeding with clots and the presence of a CRL at first scan. Conclusions: The rate of miscarriage in our IPUVI populati...