Early Diagnosis of Tubal Pregnancy: Changes in Tubal Blood Flow Evaluated by Endovaginal Color Doppler Sonography

Kirchler, H.; Seebacher, Stephan; Alge, A; Müller‐Holzner, Elisabeth; Fessler, Siegfried; Kölle, D.

doi:10.1097/00006250-199310000-00017

Cited by 21 publications

(7 citation statements)

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“…This noninvasive approach has been shown to be helpful in diagnosing intrapelvic hemorrhagic disorders, especially ectopic pregnancy. [7][8][9][10][11][12][13][14][15][16][17][18] However, the usefulness of TV-CDU for diagnosing ectopic pregnancy remains controversial, 13,14 because ectopic pregnancies tend to appear as a small ences between ectopic masses and corpus luteum cysts with respect to the characteristics of blood flow. 8 However, we suggest that the usefulness of detecting and/or analyzing the blood flows in such questionable adnexal masses adjacent to a corpus luteum cyst is low.…”

Section: Discussionmentioning

confidence: 99%

“…However, in other studies (including the current study) it has been suggested that an RI cutoff value of 0.40 is inadequate for use in the diagnosis of ectopic pregnancy because many RI values for the ectopic blood flows were greater than 0.40. 7,[13][14][15] Moreover, in another recent study it was reported that both low and high RI values can be used to discriminate ectopic pregnancies from corpus luteum cysts, 16 and in that study a high RI (>0.7) was observed in 25 of the 80 (31%) patients with ectopic pregnancies. However, the reason for the high RI values observed in the ectopic masses was discussed only to a limited extent in that report.…”

mentioning

confidence: 81%

“…Recently, transvaginal color Doppler ultrasound (TV-CDU) has been suggested to be helpful in diagnosing ectopic pregnancy. [7][8][9][10][11][12][13][14][15][16][17][18] However, controversy remains regarding the usefulness of TV-CDU for ectopic pregnancy because the pregnancy not only produces an obscure small mass in the adnexa but also various clinical features such as tubal rupture, tubal abortion, or spontaneous resolution. [1][2][3][4] In addition, chorionic diseases occasionally need to be clinically ruled out.…”

Section: Introductionmentioning

confidence: 99%

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Sonographic findings of transvaginal color Doppler ultrasound in ectopic pregnancy

et al. 2006

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Section: Introductionmentioning

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Sonographic findings of transvaginal color Doppler ultrasound in ectopic pregnancy

et al. 2006

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“…The results showed statistical significance in the mean between-side difference of tubal blood flow; meaning, there was a larger difference between the side of the ectopic pregnancy and the normal side as compared to between-side differences of two normal fallopian tubes in women with an intrauterine pregnancy. 35 Salim looked at blood flow in the corpus lutei of normal, abnormal intrauterine pregnancies and ectopic pregnancies and found no statistical significance between ectopic, anembryonic or molar pregnancies and normal pregnancies. 36 Atri also studied pregnancies to see if there was a difference in the resistive indices of an ectopic pregnancy and a corpus luteum cyst of pregnancy-both entities which can be confused with one another.…”

Section: Doppler/3d Ultrasoundmentioning

confidence: 99%

Ectopic Pregnancy and Ultrasound: A Review

Busse¹

2007

Donald School Journal of Ultrasound in Obstetrics and Gynecology

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First trimester bleeding occurs in up to 30% of all diagnosed pregnancies. Important causes of first trimester bleeding include spontaneous abortion, missed or threatened abortion, ectopic pregnancy, and gestational trophoblastic disease. One of the greatest dilemmas for clinicians is to accurately diagnose the cause of pain or bleeding, and specifically to determine if an ectopic pregnancy exists due to its grave consequences. Ectopic pregnancy occurs in almost two percent of all reported pregnancies in the United States and is the leading cause of pregnancy-related death in first trimester. When an early pregnant patient is identified who has bleeding or pain, it is crucial step to determine where the pregnancy is located. Ultrasound as a first line diagnostic tool offers an excellent opportunity for pregnancy localization. The use of the beta subunit of human chorionic gonadotropin (beta-hCG) quantification is a valuable adjunct to help determine the course and possible outcome of an early pregnancy. The goal should be to preserve the health and future reproductive capabilities of our patients.

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“…These reports have generally concentrated on color flow imaging of the adnexa and have concluded that color flow imaging improves the sensitivity of TVS for detecting ectopic pregnancies. [15][16][17][18] Although it has been noted previously that trophoblastic endometrial flow is not present with an ectopic pregnancy, the utility of endometrial color flow/imagedirected Doppler imaging for lowering the risk of ectopic pregnancy whether an IUP sac is present or not has been described in far less detail. 14,17,19 Toward this goal, we have prospectively evaluated the utility and pitfalls of utilizing color flow/ image-directed Doppler imaging of the endometrium to exclude ectopic pregnancies.…”

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confidence: 99%

Endometrial color flow/image-directed Doppler imaging: Negative predictive value for excluding ectopic pregnancy

Dubinsky

Parvey

Maklad

1997

J. Clin. Ultrasound

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Purpose Visualization of an intrauterine pregnancy with transvaginal ultrasound virtually excludes an ectopic pregnancy. However, findings that might lower patients' risk for ectopic pregnancy have not been extensively investigated. We prospectively performed transvaginal color flow/image‐directed Doppler imaging of the endometrium to determine the predictive value of endometrial blood flow for excluding ectopic pregnancy. Materials and Methods From April 1994 to August 1995, 211 consecutive women underwent transvaginal ultrasound examinations to exclude an ectopic pregnancy. Color flow/image‐directed Doppler imaging of the endometrium was performed on each patient. Flow was considered to be present only if a Doppler signal could be obtained with the cursor located completely within the endometrium. All Doppler imaging parameters were optimized for each patient. Resistive indices were obtained if arterial signal was present, and receiver operator characteristic curves were constructed for RI and peak systolic velocity. Findings were correlated with surgical and pathology results. Results Of 211 total patients, there were 55 ectopic pregnancies (52 diagnosed for a sensitivity of 95%), 89 incomplete spontaneous abortions, 40 completed spontaneous abortions, and 27 intrauterine pregnancies. Of 55 ectopic pregnancies diagnosed with real time imaging, 9 had areas of endometrial blood flow (6 venous, 3 arterial), and 46 did not. Of the 156 patients that did not have an ectopic pregnancy, 107 had arterial blood flow within the endometrium, and 49 had no flow. Using only cases with arterial signal, the negative predictive value of endometrial blood flow for excluding an ectopic pregnancy was 97% (107/107 + 3). The optimal cutoff values (5% false‐positive rate) for peak systolic velocity and refractive index (RI) were 15 cm/s and 0.55. Conclusions Arterial blood flow within the endometrium lowers the risk for ectopic pregnancy even when other findings that might indicate a high risk are present. Venous flow within the endometrium does not exclude an ectopic pregnancy. © 1997 John Wiley & Sons, Inc. J Clin Ultrasound 25: 103–109, 1997.

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Early Diagnosis of Tubal Pregnancy: Changes in Tubal Blood Flow Evaluated by Endovaginal Color Doppler Sonography

Cited by 21 publications

References 0 publications

Sonographic findings of transvaginal color Doppler ultrasound in ectopic pregnancy

Sonographic findings of transvaginal color Doppler ultrasound in ectopic pregnancy

Ectopic Pregnancy and Ultrasound: A Review

Endometrial color flow/image-directed Doppler imaging: Negative predictive value for excluding ectopic pregnancy

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