Document Detail

Utility of dilation and curettage in the diagnosis of pregnancy of unknown location.
MedLine Citation:
PMID:  21284966     Owner:  NLM     Status:  In-Data-Review    
OBJECTIVE: We sought to determine utility of uterine evacuation for diagnosis of nonviable pregnancy of unknown location (PUL).
STUDY DESIGN: We conducted a cohort study to assess the prevalence of ectopic pregnancy (EP), overall, and stratified by presenting signs and symptoms in women with a nonviable PUL.
RESULTS: Of the 173 women, 66 (38%) had miscarriage (spontaneous abortion [SAB]) and 107 (62%) had EP. When initial human chorionic gonadotropin (hCG) was <2000 mIU/mL, the odds of an EP were greater (odds ratio, 4.32; 95% confidence interval, 2.04-9.12). Demographic factors, obstetric history, and clinical presentation were not useful in distinguishing between EP and SAB. Pre-evacuation hCG increase had strong trend association with EP (odds ratio, 2.14; 95% confidence interval, 0.98-4.68). A >30% fall in postcurettage hCG was suggestive, but was not a diagnostic indicator of SAB.
CONCLUSION: Uterine evacuation is a useful diagnostic aid for women with nonviable PUL. Nondiagnostic ultrasound findings and absolute and serial hCG values are associated with, but do not accurately predict final diagnosis.
Alka Shaunik; Jennifer Kulp; Dina H Appleby; Mary D Sammel; Kurt T Barnhart
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  204     ISSN:  1097-6868     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  130.e1-6     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011. Published by Mosby, Inc.
Department of Obstetrics and Gynecology, University of Pennsylvania School of Medicine, Philadelphia, PA.
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