Document Detail

Why are some ectopic pregnancies characterized as pregnancies of unknown location at the initial transvaginal ultrasound examination?
MedLine Citation:
PMID:  18846452     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To compare the appearance and behavior of ectopic pregnancies (EPs) initially classified as pregnancies of unknown location (PULs) to those visualized on the initial transvaginal ultrasound scan (TVS). METHODS: An observational study over a four-year period on women undergoing a TVS prior to diagnosis of a tubal EP. Demographic details, presenting symptoms, TVS findings, serum hCG and progesterone levels were recorded at the time of the initial TVS and at the time of diagnosis of the EP in those initially classified as a PUL. RESULTS: 411 women with a tubal EP underwent a TVS prior to treatment. In 85.9% (353/411) the EP was visualized on the initial TVS while 14.1%(58/411) were initially classified as PULs. Those initially classified as PULs had significantly lower mean gestational age and mean initial human chorionic gonadotrophin (hCG) levels, and significantly higher mean progesterone level at presentation than those where the EP was visualized on the initial TVS. Of those with a PUL, 60.3% (35/58) had the EP subsequently visualized on TVS. At the time of diagnosis these EPs were significantly smaller (p<0.0001); the appearance of the EPs, serum hCG and progesterone levels at the time of visualization on TVS were not significantly different from those visualized on the initial TVS. CONCLUSION: In women with EPs who are initially classified as PULs, failure of visualization of the EP on the initial TVS is likely to be due to the fact that they are too small and probably too early in the disease process.
Emma Kirk; Anneleen Daemen; Aris T Papageorghiou; Cecilia Bottomley; George Condous; Bart De Moor; Dirk Timmerman; Tom Bourne
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  87     ISSN:  1600-0412     ISO Abbreviation:  Acta Obstet Gynecol Scand     Publication Date:  2008  
Date Detail:
Created Date:  2008-11-21     Completed Date:  2008-12-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  1150-4     Citation Subset:  IM    
Early Pregnancy and Gynaecological Unit, St George's, University of London, UK.
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MeSH Terms
Chorionic Gonadotropin / blood*
Gestational Age*
Predictive Value of Tests
Pregnancy Trimester, First*
Pregnancy, Ectopic / diagnosis,  therapy,  ultrasonography*
Progesterone / blood*
Sensitivity and Specificity
Ultrasonography, Prenatal / methods,  standards*
Reg. No./Substance:
0/Chorionic Gonadotropin; 57-83-0/Progesterone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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