Ectopic Pregnancy: Prospective Study With Improved Diagnostic Accuracy☆☆☆★★★

Kaplan, Barry; Dart, Robert; Moskos, Margo; Kuligowska, Ewa; Chun, Byungyol; Hamid, M.Adel; Northern, Katherine; Schmidt, Joseph D.; Kharwadkar, Ashlesha

doi:10.1016/s0196-0644(96)70131-2

Cited by 171 publications

(84 citation statements)

References 23 publications

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“…[6][7][8] The diagnostic strategies currently used for EP are limited. 9,10 Studies of the use of different markers to differentiate between an intrauterine and extrauterine pregnancy have not been optimal. 8,[11][12][13][14][15][16] Follow-up care, treatment, and prognosis for a woman at risk for an EP depend on an accurate determination of both the location of a pregnancy (intrauterine or extrauterine) and the viability of a pregnancy.…”

mentioning

confidence: 99%

Prediction of Outcome in Women with Symptomatic First-Trimester Pregnancy: Focus on Intrauterine Rather Than Ectopic Gestation

Casanova

Sammel

Chittams

et al. 2009

Journal of Women's Health

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Objective: Symptoms of vaginal bleeding and abdominal pain are common in cases of ectopic pregnancy (EP), spontaneous abortions (SAB), and complications of an intrauterine pregnancy (IUP). It is important to determine if efforts should focus on differentiating EP from an IUP (IUP ϩ SAB) or a viable IUP from a nonviable gestation (EP ϩ SAB) in women at risk for EP. Methods: This is a retrospective cohort study of women who presented with bleeding or pain or both during the first trimester of pregnancy. The cohort was divided into subjects diagnosed with IUP vs. (EP ϩ SAB). The same cohort was then divided into subjects diagnosed with EP vs. (IUP ϩ SAB). Logistic regression models based on risk factors for both outcomes (EP vs. Conclusions: Information collected at initial presentation from women at risk for EP to be used for building prediction rules should focus on differentiating a viable from a nonviable pregnancy rather than attempting to distinguish an extrauterine from an intrauterine pregnancy. However, this distinction should not affect current clinical care. 195

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mentioning

confidence: 99%

Prediction of Outcome in Women with Symptomatic First-Trimester Pregnancy: Focus on Intrauterine Rather Than Ectopic Gestation

Casanova

Sammel

Chittams

et al. 2009

Journal of Women's Health

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“…6,21,22 PID was observed in 19.4% of the patients with ectopic pregnancy which was in accordance to other studies, who reported a high association between PID. 16,19,23,24 Tubal ligation was another risk factor which attributed to the increased incidence of ectopic pregnancy, which was observed in around 48% of the cases, while tubal damage was observed in nearly 20% of the cases. 76% of pregnancies after sterilization were ectopic in a study by Kier et al 25 …”

Section: Discussionmentioning

confidence: 99%

Risk factors of ectopic pregnancy: a study in a tertiary care centre

Neelima

Vanamala

2017

Int J Reprod Contracept Obstet Gynecol

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Background: Over the years, there has been a considerable rise in the incidence of ectopic pregnancy. This study was undertaken to identify the risk factors that contribute to this condition, so that immediate action can be taken so as to save the mother.Methods: 62 women, in their first trimester of pregnancy who were diagnosed with ectopic pregnancy were included in the study. Demographic details, clinical and obstetric details were taken from all the patients. Ultrasound was performed to confirm the ectopic pregnancy.Results: Out of the 62 patients, most of them with ectopic pregnancy were found to be in the 26-30 (40.3%) year’s age group. Smoking, whether active or passive was observed in nearly 42% of the cases. The mean gravid status among the women was 3, with 34 live births. 21 of them had induced abortions and 4 were spontaneous. PID was observed in 12 patients (19.4%), 17.7% were IUD users.Conclusions: Risk factors such as previous ectopic pregnancy, use of contraceptives, infertility, PID, abortion as well as increased maternal age aid in the early detection of ectopic pregnancy in women resulting in proper and timely treatment.

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“…In a prospective study of 6621 consecutive women with an early pregnancy, 85% of whom presented with pain and/or bleeding, tubal pregnancy was correctly diagnosed with transvaginal ultrasound with a sensitivity 91% and a specificity of 99.9% [5]. The sensitivity and specificity of transvaginal ultrasound with regard to tubal pregnancy are shown in Table 1 [5][6][7][8][9]. The table shows that transvaginal ultrasound is an excellent method for confirming or excluding tubal pregnancy, but sensitivity and specificity are likely to depend highly on the skill of the examiner and on the quality of the ultrasound equipment used.…”

Section: Bleeding And/or Pain In Early Pregnancymentioning

confidence: 99%

Imaging in gynecology

Valentin

2006

Best Practice & Research Clinical Obstetrics & Gynaecol

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This chapter summarizes the diagnostic performance (sensitivity, specificity, positive and negative likelihood ratios) of ultrasound, computer tomography, and magnetic resonance imaging in the diagnosis of various gynecological diseases and tumors. Positron emission tomography is not discussed. Imaging in infertility, in the diagnosis of Mullerian duct anomalies and in gynecological oncology (staging of gynecological cancers, diagnosis of recurrence of gynecological cancer, diagnosis of trophoblastic tumors) is not dealt with.Ultrasound is the first line imaging method for discrimination between viable intrauterine pregnancy, miscarriage and tubal pregnancy in women with bleeding and/or pain in early pregnancy, for discrimination between benign and malignant adnexal masses and for making a specific diagnosis in adnexal tumors (e.g., dermoid cyst, endometrioma, hemaorrhagic corpus luteum, ectetera), for diagnosing intracavitary uterine pathology in women with bleeding problems, and for confirming or refuting pelvic pathology in women with pelvic pain. Magnetic resonance imaging may have a role as a secondary test in the diagnosis of adenomyosis, 'deep endometriosis' (e.g., endometriosis in the rectovaginal septum or in the utero-sacral ligaments), and in the diagnosis of extremely rare types of ectopic pregnancy (e.g., in the spleen, liver or retroperitoneum).

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Ectopic Pregnancy: Prospective Study With Improved Diagnostic Accuracy☆☆☆★★★

Cited by 171 publications

References 23 publications

Prediction of Outcome in Women with Symptomatic First-Trimester Pregnancy: Focus on Intrauterine Rather Than Ectopic Gestation

Prediction of Outcome in Women with Symptomatic First-Trimester Pregnancy: Focus on Intrauterine Rather Than Ectopic Gestation

Risk factors of ectopic pregnancy: a study in a tertiary care centre

Imaging in gynecology

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