Ultrasound in Pregnancy

Hsu, Sam; Euerle, Brian D.

doi:10.1016/j.emc.2012.08.001

Cited by 14 publications

(10 citation statements)

References 22 publications

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“…The ultrasonic manifestations of HP ectopic lesions can be divided into direct signs and indirect signs: the direct signs are the gestational sac, yolk sac, even germ and fetal heart with ectopic pregnancy; the indirect signs include mixed echo mass and abdominal pelvic effusion. The diversity of ultrasonic manifestations leads to the uncertainty of ultrasonic diagnosis [6,7]. Therefore, the diagnosis of HP should be combined with the patient's history, clinical manifestations and ultrasound ndings.…”

Section: Discussionmentioning

confidence: 99%

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Clinical Analysis of 47 Cases of Heterotopic Pregnancy After Assisted Reproductive Technology

Bei¹,

Liu²,

Xu³

2021

Preprint

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Background: Heterotopic pregnancy is rare in natural pregnancy. In recent years, with the development of assisted reproductive technology, the incidence of heterotopic pregnancy is increasing. Heterotopic pregnancy not only affects the development of intrauterine embryo, but also threatens the life of patients. There is no unified standard for the treatment of heterotopic pregnancy until now. So we research the clinical features and the effect of different intervention time on pregnancy outcome in patients with heterotopic pregnancy (HP) after assisted reproductive technology (ART).Methods: A retrospective analysis was conducted on the patients who were diagnosed as HP in Shanghai first maternal and infant hospital after conception through ART from January 2014 to June 2019. We analyzed the clinical characteristics, therapeutic method and intervention time to explore their impact on the outcome of HP.Results：47 patients with HP after ART were treated in our hospital and have complete clinical data. Among them, 18 cases treated with conservative therapy and 29 cases treated with operation. 29 cases delivered (including 3 cases of pre-term birth and 26 cases of full-term birth) and 18 cases aborted. In HP patients, β Human chorionic gonadotropin (β-HCG, 0.617) and extrauterine mass size (0.242) are not much guiding significance for the treatment. Transvaginal ultrasonography (TVS) examination on admission found that different conditions of ectopic (anechoic area, adnexal mass, heart beat, yolk sac) was independent risk factors of different treatment methods (P=0.005). And the intervention time before six weeks can get better pregnancy outcome (p=0.034).Conclusions：Patients with ART should be examined by TVS as early as possible. If abnormal TVS (anechoic area, adnexal mass, heart beat, yolk sac) results are found, patients should be operated by laparoscopy. And the best intervention time of laparoscopy is before 6 weeks.

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Section: Discussionmentioning

confidence: 99%

“…The ultrasonic manifestations of HP ectopic lesions can be divided into direct signs (gestational sac, yolk sac, even germ and fetal heart) and indirect signs (mixed echo mass and abdominal pelvic effusion). The diversity of ultrasonic manifestations leads to the uncertainty of ultrasonic diagnosis [6,7].…”

Section: Introductionmentioning

confidence: 99%

Clinical Analysis of 47 Cases of Heterotopic Pregnancy After Assisted Reproductive Technology

Bei¹,

Liu²,

Xu³

2021

Preprint

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“…The localization, thickness, and structure of the chorion were also estimated. 12,17,18 Fetometry, measurements of the quantity of amniotic fluid present, and placentometry were performed by ultrasound during the second trimester. The echostructure, location, and thickness of the placenta as well as the state of the intervillous space, the presence of calcification, and the presence of additional placental lobes were described.…”

Section: Methodsmentioning

confidence: 99%

Ultrasound Features of the Formation of the Maternal-Placental Complex in Cases of Hyperandrogenism as Observed during the First and Second Trimesters of Pregnancy

Olga¹,

Elena²,

Luybov³

et al. 2014

Donald School Journal of Ultrasound in Obstetrics and Gynecology

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An excess of maternal androgen adversely affects the implan tation process and contributes to uterine circulatory disturbances and myometrium vessel sclerosis. Placental insufficiency is typi cally diagnosed at the end of the second trimester of pregnancy or at the beginning of the third trimester, when the treatment is not effective.Many researchers have attempted to use early sonographic diagnostics to identify placental failure in various pathological states. Nevertheless, the peculiarities of the formation of the fetal-placental complex during the first and second trimesters are still undefined. In this study, we traced the process of placental formation under conditions of excess maternal androgen using ultrasound and Dopplerometry. Morphological examinations of the сhorion and placental tissue were undertaken to сompare any changes.Unfavorable chorion locations, heterogeneous chorion tis sue structures, and marginal sinus dilatations were revealed by ultrasound. According to a Dopplerometric investigation, a statistically significant increase in peripheral vessel resistance in cases of hyperandrogenism was identified compared with healthy pregnancies. The negative influence of hyperandrogenism on placental formation was confirmed by morphologi cal data (including the presence of immature decidual cells, defec tive villi that covered the epithelium, and the dissociative development of cotyledons).

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“…CK levels were higher in the isthmic localization of EP because damage to muscle infiltration in this part of the tuba occurs more rapidly in less time. Currently, the most valuable tests for the diagnosis of EP are the measurement of human beta-chorionic gonadotropin (β-hCG) in serum and transvaginal ultrasound (TVUS) screening [13].…”

Section: Original Articlementioning

confidence: 99%

Prediction value of creatine kinase level in conservative treated unruptured tubal ectopic pregnancies

OCAKOGLU

Develíoğlu²

2021

The European Research Journal

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Objectives: An ectopic pregnancy (EP) occurs when a fertilized ovum implants outside the endometrial cavity. We investigated the creatine kinase (CK) enzyme in conservatively treated EP to determine the resolution time and predict cases that may progress to surgical intervention. Methods: We include 43 patients with stable vital signs at recruitment. All participants were examined by using transvaginal ultrasound (TVUS). Beta human chorionic gonadotropin (β-hCG) and creatine kinase (CK) levels were also measured. In cases diagnosed with EP, intramuscular methotrexate (MTX) at a dose of 50 mg / m2 was administered and monitored with β-hCG titers. Follow-up continued until β-hCG titer became negative, or surgery became mandatory due to acute abdominal pain. Results: The mean β-hCG Level in the presence of an adnexal mass was statistically significantly higher than the mean level in patients in whom TVUS failed to define a mass. The mean β-hCG level in the surgical exploration group of patients was significantly higher than in those who did not require surgery. At a cut-off of 6486 mIU/mL, β-hCG could predict the emergence of acute abdomen with a sensitivity of 75% and a specificity of 94.3%. We examined CK level to contribute the test's specificity, but we found no difference among cases with and without surgical exploration. Conclusions: In patients treated conservatively for EP, CK levels at the outset neither predict an acute abdomen to emerge nor shed light on the resolution period in patients who respond to medical therapy.

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Ultrasound in Pregnancy

Cited by 14 publications

References 22 publications

Clinical Analysis of 47 Cases of Heterotopic Pregnancy After Assisted Reproductive Technology

Clinical Analysis of 47 Cases of Heterotopic Pregnancy After Assisted Reproductive Technology

Ultrasound Features of the Formation of the Maternal-Placental Complex in Cases of Hyperandrogenism as Observed during the First and Second Trimesters of Pregnancy

Prediction value of creatine kinase level in conservative treated unruptured tubal ectopic pregnancies

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