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Culdocentesis followed by saline solution-enhanced ultrasonography: technique for evaluation of suspected ectopic pregnancy.
MedLine Citation:
PMID:  20656566     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
STUDY OBJECTIVE: To evaluate the use of a technique consisting of culdocentesis followed by saline solution-enhanced pelvic ultrasonography in cases suspect for ectopic pregnancy in which an accurate diagnosis could not be made using routine transvaginal ultrasound.
DESIGN: Retrospective clinical study (Canadian Task Force classification III).
SETTING: Academic medical center.
PATIENTS: Twenty patients with an initial diagnosis of pregnancy of unknown location.
INTERVENTIONS: In 20 patients with symptoms of early pregnancy and serum quantitative human chorionic gonadotropin concentration, ectopic pregnancy could not be confirmed or ruled out. Transvaginal ultrasound-guided culdocentesis was performed, and 300 to 400 mL of normal saline solution was injected into the posterior cul-de-sac and pelvis. Transvaginal ultrasound was repeated with particular attention to the floating fallopian tubes
MEASUREMENTS AND MAIN RESULTS: Using this technique, a tubal pregnancy was visualized in 15 of 20 patients, and ectopic pregnancy was ruled out in 5 patients. In all patients, appropriate management was provided according to the final diagnosis, and consisted of either methotrexate, laparoscopic salpingostomy or salpingectomy, or expectant management in patients with abnormal intrauterine pregnancies.
CONCLUSION: Ultrasound-guided culdocentesis followed by saline solution-enhanced pelvic ultrasound can be considered as a diagnostic tool in patients with suspected ectopic pregnancy in whom other methods fail to demonstrate this diagnosis.
Authors:
Tamer M Yalcinkaya; Shon P Rowan; Munire Erman Akar
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Publication Detail:
Type:  Journal Article     Date:  2010-07-24
Journal Detail:
Title:  Journal of minimally invasive gynecology     Volume:  17     ISSN:  1553-4650     ISO Abbreviation:  J Minim Invasive Gynecol     Publication Date:    2010 Nov-Dec
Date Detail:
Created Date:  2010-10-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101235322     Medline TA:  J Minim Invasive Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  754-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 AAGL. Published by Elsevier Inc. All rights reserved.
Affiliation:
Departments of Obstetrics and Gynecology, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
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