How to measure size of tubal ectopic pregnancy on ultrasound

Rajah, K.; Goodhart, Venetia; Zamora, Katherine; Amin, T.; Jauniaux, Eric

doi:10.1002/uog.18958

Cited by 12 publications

(16 citation statements)

References 14 publications

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“…The diagnosis of EUEP on TVS was based on findings of a structure outside the uterus with typical morphological features of an EUEP and morphological classification was based on the characteristics summarized in Figure . Hemoperitoneum was classified as mild, moderate or severe, based on the location and quality of the blood seen on TVS (Figure ).…”

Section: Methodsmentioning

confidence: 99%

Effect of morphological type of extrauterine ectopic pregnancy on accuracy of preoperative ultrasound diagnosis

Dooley

Chaggar

Braud

et al. 2019

Ultrasound in Obstet & Gyne

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Objectives To assess the overall accuracy of transvaginal ultrasound (TVS) for diagnosis of all types of extrauterine ectopic pregnancy (EUEP) in a large group of women who were managed surgically. We also aimed to assess the positive predictive value (PPV) of TVS for each of the different ultrasound morphological types of EUEP. Methods This was a retrospective observational study of all pregnant women who underwent emergency surgery following ultrasound diagnosis of EUEP at a single early pregnancy unit between January 2009 and December 2017. The preoperative TVS findings were recorded, including the exact location and morphological type (Type I–V; defined using ultrasound criteria) of EUEP. TVS findings were compared with operative and histological findings. The performance of ultrasound in diagnosing EUEP overall and according to morphological type was assessed, using visual confirmation of ectopic pregnancy at surgery as the reference standard. Results A total of 26 401 women presented with early‐pregnancy complications during the study period, including 1241 (4.7%; 95% CI, 4.5–5.0%) women with a conclusive diagnosis of EUEP on TVS or a presumed diagnosis based on severe pain and significant hemoperitoneum. Surgery was performed in 721/1241 (58.1%; 95% CI, 55.3–60.8%) cases, of which 710 (98.5%; 95% CI, 97.6–99.4%) had a conclusive diagnosis of EUEP on preoperative TVS. The remaining 11 women had severe pain and significant hemoperitoneum and were managed surgically on clinical grounds as an emergency, without an ectopic pregnancy having been identified on ultrasound examination. At laparoscopy, the diagnosis of EUEP was confirmed in 706/710 (99.4%; 95% CI, 98.6–99.8%) women with a positive ultrasound diagnosis and in all 11 women with a presumed ultrasound diagnosis of EUEP. The PPV of preoperative ultrasound for the diagnosis of EUEP was 99.4% (95% CI, 98.6–99.8%) with sensitivity of 98.5% (95% CI, 97.3–99.1%). There was no statistically significant difference in the accuracy of preoperative ultrasound diagnosis between the five morphological types (P = 0.76). Conclusions The accuracy of preoperative ultrasound for diagnosis of EUEP is high. The morphological type of EUEP on TVS had no significant effect on the accuracy of preoperative diagnosis. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.

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Section: Methodsmentioning

confidence: 99%

Effect of morphological type of extrauterine ectopic pregnancy on accuracy of preoperative ultrasound diagnosis

Dooley

Chaggar

Braud

et al. 2019

Ultrasound in Obstet & Gyne

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“…Table (4) and Figs. (3,4) show that: Cases with Leash sign had ststistically significant lower progesterone level and more frequent ectopic pregnancy. (p-values <0.001).…”

Section: Discussionmentioning

confidence: 97%

“…On the other hand, of an intrauterine pregnancydetection clinical presence of ectopic pregnancy unlikely. Sonography is correlated with earlier clinical diagnosis in various research studies in tertiary centres in low income communities [1][2][3][4][5] .…”

Section: Introductionmentioning

confidence: 99%

The Predictive Value of Combining Leach Sign and Serum Progesterone in Diagnosis of Undisturbed Ectopic Pregnancy

M¹,

ETMAN

2018

The Medical Journal of Cairo University

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“…Furthermore, β-HCG levels did not correlate with intra-abdominal hemorrhage (p > 0.05), confirming the absence of a lower cut-off limit which would reasonably exclude hemorrhage or transmural rupture. Our internal directive, therefore, bases the indication for follow-up sonography mainly on the specific sono-graphic findings and patient-reported symptoms at the initial visit rather than on the β-HCG level [4,19].…”

Section: Discussionmentioning

confidence: 99%

“…In cases of equality, we chose the one with the bigger maximal outer-outer diameter. We also defined and analyzed another four well-known ECP indications through TVS per experience and literature: decidual thickness [10], presence of a pseudogestational sac (PGS) [16,24], maximal ECP size [19], and FF semiquantitatively assessed [16,19,20], distinguishing between liquid and clotted (▶ Fig. 3).…”

Section: Methodsmentioning

confidence: 99%

The Predictive Value of Decisive and Soft Ultrasound Criteria for Ectopic Pregnancy Identification in 321 Preoperative Cases

et al. 2021

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Purpose To define the predictive value of morphological types (MTs) and further criteria in diagnosing ectopic pregnancy (ECP) by transvaginal sonography (TVS) prior to operative confirmation and treatment. Materials and Methods Retrospective cohort analysis of 321 consecutive patients with suspected ECP who were advised to undergo operation. Results ECP was investigated by TVS in all 321 patients. Application of the five selected MTs (blob sign, bagel sign, yolk sac, embryo, heart action) resulted in 85 % of cases receiving a conclusive diagnosis and 12 % receiving a presumed ECP diagnosis. 3 % remained nondiagnostic due to large or multiple ovarian cysts, large myoma, extended hemoperitoneum, or severe pain. ECP diagnosis was confirmed intraoperatively in 97 % of cases and was otherwise (3 %) immediately followed by curettage (CUR). The assessment of free fluid by TVS was achieved in most cases and correlated significantly with free blood. In the majority of cases, free blood was not bound to transmural ECP rupture. Histology confirmed the ECP diagnosis directly or by exclusion in 99 % of cases. Three cases of tubal ECP were diagnosed by TVS but not confirmed by LSC (1 %) and, finally, histology from CUR proved miscarriage (false-positive rate 1 %). Conclusion We confirm the high accuracy of TVS diagnosis of ECP relying on five clearly different MTs, independent of its location. The blob and bagel sign emerged as important types (75 % of all ECPs). Histology from CUR was needed when ECP could not be visualized in LSC. Assessment of free fluid was essential and accurate in predicting free blood.

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How to measure size of tubal ectopic pregnancy on ultrasound

Cited by 12 publications

References 14 publications

Effect of morphological type of extrauterine ectopic pregnancy on accuracy of preoperative ultrasound diagnosis

Effect of morphological type of extrauterine ectopic pregnancy on accuracy of preoperative ultrasound diagnosis

The Predictive Value of Combining Leach Sign and Serum Progesterone in Diagnosis of Undisturbed Ectopic Pregnancy

The Predictive Value of Decisive and Soft Ultrasound Criteria for Ectopic Pregnancy Identification in 321 Preoperative Cases

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