TITLE

The diagnostic effectiveness of an initial transvaginal scan in detecting ectopic pregnancy

AUTHOR(S)
Emma Kirk; Aris T. Papageorghiou; George Condous; Linda Tan; Shabana Bora; Tom Bourne
PUB. DATE
November 2007
SOURCE
Human Reproduction;Nov2007, Vol. 22 Issue 11, p2824
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
BACKGROUND To determine the effectiveness of an initial transvaginal ultrasound scan (TVS) in the detection of ectopic pregnancy in consecutive women attending an early pregnancy unit (EPU). METHODS This was a prospective observational study. Unselected women attending a dedicated EPU underwent a TVS. Women were classified as having an intrauterine pregnancy (IUP), ectopic pregnancy or pregnancy of unknown location (PUL). Women with a PUL were followed up until the final location of the pregnancy was determined. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) with 95% confidence intervals (CIs) for the initial TVS in the diagnosis of ectopic pregnancy were calculated. RESULTS During a one-year study period, 5318 consecutive women attended the EPU. Outcome data were available for 5240 (98.5%) women. Of these, the initial TVS showed an IUP in 4693 (89.6%) cases and an ectopic pregnancy in 91 (1.7%) cases. The remaining 456 (8.7%) women were classified as PUL, and of these 31 (6.8%) were subsequently found to have ectopic pregnancies. The overall sensitivity of the initial TVS in the diagnosis of ectopic pregnancy was 73.9% (95% CI: 65.1–81.6) with a specificity of 99.9% (95% CI: 99.8–100), a PPV of 96.7% (95% CI: 90.7–99.3) and an NPV of 99.4% (95% CI: 99.2–99.6). CONCLUSIONS In unselected women attending an EPU, pregnancy location can be diagnosed accurately in over 90% of all pregnancies and in 73.9% of ectopic pregnancies with a single TVS.
ACCESSION #
27099844

 

Related Articles

  • Salpingotomy or salpingectomy in tubal ectopic pregnancy: What do women prefer? van Mello, N. M.; Mol, F.; Opmeer, B. C.; de Bekker-Grob, E. W.; Essink-Bot, M. L.; Ankum, W. M.; Mol, B. W.; van der Veen, F.; Hajenius, P. J. // Reproductive BioMedicine Online (Reproductive Healthcare Limited;Nov2010, Vol. 21 Issue 5, p687 

    There is an ongoing debate whether tubal ectopic pregnancy should be treated by salpingotomy or salpingectomy. It is unknown which treatment women prefer in view of the potentially better fertility outcome but disadvantages of salpingotomy. This study investigated women surgically treated for...

  • Predictors of Success of Methotrexate Treatment in Women with Tubal Ectopic Pregnancies. Lipscomb, Gary H.; McCord, Marian L.; Stovall, Thomas G.; Huff, Genelle; Portera, S. Greg; Ling, Frank W. // New England Journal of Medicine;12/23/99, Vol. 341 Issue 26, p1974 

    Background: The use of methotrexate for the treatment of women with tubal ectopic pregnancies is now common practice. However, the clinical and hormonal determinants of the success of this treatment are not known. Methods: We studied 350 women with tubal ectopic pregnancies who were treated with...

  • Intrauterine pregnancy following transperitoneal oocyte and/or sperm migration in a woman with an ectopic (undescended) ovary. Ombelet, Willem // Reproductive BioMedicine Online (Reproductive Healthcare Limited;Jul/Aug2003, Vol. 7 Issue 1, p110 

    Presents a case study on intrauterine pregnancy following transperitoneal oocyte and sperm migration in a woman with an ectopic ovary. Medical history of the patient; Physiologic mechanisms which led to the failure of ovary descent; Results and discussion.

  • To Evaluate the Efficacy of Laparoscopic versus Open Surgical Management of the Tubal Pregnancy and its Effects on Future Pregnancy. Tembhare, Amardeep Bhimrao // World Journal of Laparoscopic Surgery;Sep-Dec2010, Vol. 3 Issue 3, p153 

    Ectopic pregnancy is the most common cause of maternal death in early pregnancy and its incidence is rising. Most of the ectopic pregnancies occur in the young age group and subsequent fertility is an important issue. There is no consensus in the literature regarding conservative laparoscopic...

  • Cervical ectopic pregnancy: Mersilene tape in surgical management. Bamigboye, A. A.; Ojo, O. A. // South African Journal of Obstetrics & Gynaecology;2014, Vol. 20 Issue 2, p63 

    In view of the rarity of cervical ectopic gestation and the potentially high morbidity that may be associated with its presentation and management, we report management of a case of cervical ectopic pregnancy using cervical cerclage with Mersilene tape as an intervention to reduce intraoperative...

  • An Ectopic Pregnancy in the Tubal Interstitium: Beware! SHARMA, NIDHI // Journal of Clinical & Diagnostic Research;Jan2013, Vol. 7 Issue 1, p160 

    An interstitial ectopic pregnancy is a rare and a dangerous form of an ectopic pregnancy .It presents late clinically and it is difficult to be imaged radiographically . We are presenting a case of an interstitial pregnancy which was a surprise intra operative finding. As Assisted Reproductive...

  • Bilateral ectopic pregnancy: a case report. Hsayaoui, Najeh; Mbarki, Chaouki; Cadhy, Youcef; Hamdi, Banene; Oueslati, Hedhili // Perinatal Journal / Perinatoloji Dergisi;Oct2014 Supplement, Vol. 22, pSE56 

    Introduction: Bilateral tubal pregnancy is the rarest form of ectopic pregnancy. It occurs frequently at women after undergoing assisted reproduction procedures. Objective: The aim of this study is to insist at importance of ultrasonography exam on bilateral ectopic pregnancy diagnosis. Case: We...

  • Is D&C always necessary to diagnose ectopic pregnancy?  // Contemporary OB/GYN;Dec2003, Vol. 48 Issue 12, p97 

    The article presents the responses of readers on the need for dilatation and curettage (D&C) of the uterus to diagnose ectopic pregnancy. A reader says selected patients can benefit from methotrexate without undergoing D&C. Another reader says D&C is not a treatment for tubal ectopics.

  • The Value of Hysterosalpingography following Medical Treatment with Methotrexate for Ectopic Pregnancy. Grau, Emma Garcia; Vizcaı´no, Miguel A´ ngel Checa; Oliveira, Ma´rio; Juan´ os, Judith Lleberia; Collado, Ramon Carreras; Estevez, Yolanda Canet // Obstetrics & Gynecology International;2011, Vol. 2011, p1 

    After an ectopic pregnancy (EP) fertility decreases, mostly due to tubal factor. Hysterosalpingography (HSG) is the most costeffective tool for tubal patency assessment. Objective. To evaluate the usefulness of a HSG after a medical treatment for an EP, in order to counsel women on the most...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics