Document Detail

Value of transvaginal sonography in diagnosing heterotopic pregnancy after in-vitro fertilization with embryo transfer.
MedLine Citation:
PMID:  23610036     Owner:  NLM     Status:  In-Data-Review    
OBJECTIVES: To assess the value of transvaginal sonography (TVS) in the diagnosis of heterotopic pregnancy (HP) in the first trimester after in-vitro fertilization with embryo transfer (IVF-ET).
METHODS: This was a retrospective review of women undergoing IVF-ET between January 2005 and December 2011. Women were diagnosed with an HP using TVS if a visible intrauterine gestational sac was observed with any of the following: (i) an inhomogeneous adnexal mass; (ii) an empty extrauterine gestational sac seen as a hyperechoic ring; or (iii) a yolk sac and/or fetal pole with or without cardiac activity in an extrauterine sac.
RESULTS: Overall, 16 483 consecutive women who underwent IVF had TVS during the study. Of these, 174 cases were diagnosed on TVS as having an HP, and 10 cases were missed. Fifty-two cases were treated expectantly and were excluded from the analysis. Three types of ultrasonographic presentation of ectopic pregnancy (EP) were seen in HP patients, with a gestational sac found in 70 cases, a ring sign in 21 and an adnexal mass in 31. The sensitivity and specificity of TVS for the detection of HP were 92.4 and 100%, respectively, with positive and negative predictive values of 100 and 99.9%. The HP cases comprised 103 tubal EPs and 29 non-tubal EPs. In 93 patients (70.5%), their intrauterine pregnancy resulted in a live birth, 37 patients (28.0%) suffered an early miscarriage and two patients (1.5%) had a late miscarriage.
CONCLUSION: Early TVS performed by an experienced sonographer has a high sensitivity for making the correct diagnosis of HP after IVF-ET. Copyright © 2012 ISUOG. Published by John Wiley & Sons Ltd.
X H Li; Y Ouyang; G X Lu
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  41     ISSN:  1469-0705     ISO Abbreviation:  Ultrasound Obstet Gynecol     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-04-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  England    
Other Details:
Languages:  eng     Pagination:  563-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 ISUOG. Published by John Wiley & Sons Ltd.
Institute of Reproductive and Stem Cell Engineering, Central South University, Changsha, Hunan, China; CITIC-Xiangya Reproductive & Genetic Hospital, Changsha, Hunan, China.
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