Ultrasonographic “endometrial three-layer” pattern: A unique finding in ectopic pregnancy

Evaluation of sonographic endometrial patterns and endometrial thickness as predictors of ectopic pregnancy

“…A previous study showed a sensitivity of 62% for the endometrial three‐layer pattern in the diagnosis of EP. Because the present study would add other variables, a sensitivity of 80% was expected.…”

“…Three previous studies have evaluated the value of the endometrial pattern in the diagnosis of EP. Two were retrospective studies, whereas the third had a prospective design, and only the trilaminar pattern was evaluated in all the three studies (Hammoud et al . described all four endometrial patterns, but they only evaluated use of the trilaminar pattern for the diagnosis of EP).…”

“…found the trilaminar pattern to be more specific (94%) but less sensitive (38%), with a positive predictive value of 92% and a negative predictive value of 46%. Lavie et al . reported a specificity of 100% and a sensitivity of 62% for the trilaminar pattern, with a positive predictive value of 100% and a negative predictive value of 84%.…”

“…The endometrial pattern, the endometrial thickness, and the presence of an adnexal mass and/or an extrauterine gestational sac were noted. The endometrial patterns were divided into four categories: (1) trilaminar pattern (endometrial three‐layer pattern), consisting of three hyperechoic layers separated by two intervening hypoechoic layers; (2) homogeneous hyperechoic pattern; (3) heterogenous hyperechoic pattern, defined as a mixed echogenic pattern with or without the presence of fluid in the uterine cavity and with or without cystic spaces in the endometrium; and (4) pseudogestational sac, defined as a central oval shape with a thin echogenic rim and absence of the double decidual sign . The endometrial thickness was obtained in the sagittal midline plane and measured as the maximum anteroposterior thickness as described by Bredella et al …”

“…Serial measurement of the beta subunit of hCG (β‐hCG) and TVS to identify and assess adnexal masses do not resolve the diagnostic dilemma in many affected women . The role of the endometrial pattern and thickness in the prediction of EP has been assessed in only a few studies . With this background in mind, the aim of the present study was to investigate how endometrial pattern and thickness can be used for the prediction of EP.…”