Can sonographic endometrial pattern be an early indicator for tubal ectopic pregnancy and related tubal rupture?
Purpose The present study aims to determine whether sonographic endometrial pattern can be addressed as an early indicator for tubal ectopic pregnancy and related tubal rupture in case ultrasonography reveals no adnexal mass and maternal serum beta human chorionic gonadotropin (HCG) level is below t...
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| Veröffentlicht in: | Archives of gynecology and obstetrics 2010-02, Vol.281 (2), p.189-194 |
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| creator | Col-Madendag, Ilknur Madendag, Yusuf Kanat-Pektas, Mine Danisman, Nuri |
| description | Purpose
The present study aims to determine whether sonographic endometrial pattern can be addressed as an early indicator for tubal ectopic pregnancy and related tubal rupture in case ultrasonography reveals no adnexal mass and maternal serum beta human chorionic gonadotropin (HCG) level is below the discriminatory zone (≤1,000 mIU/mL).
Methods
The study evaluated the endometrial features of 441 naturally conceived and asymptomatic first trimester (99 tubal ectopic, 138 failing and 264 normal intrauterine) with maternal serum beta HCG levels ≤1,000 mIU/mL and indeterminate sonographic findings.
Results
Tubal ectopic, failing intrauterine and normal intrauterine pregnancies are statistically similar in aspect of endometrial thickness. However, trilaminar endometrial pattern was significantly less frequent in failing and normal intrauterine pregnancies but significantly more frequent in ruptured tubal pregnancies. Also the relative risk of tubal rupture is significantly higher in case of trilaminar endometrial pattern. Trilaminar endometrial pattern has a sensitivity of 21.2%, specificity of 93.9%, positive predictive value of 50.0% and negative predictive value of 80.5% for distinguishing tubal ectopic pregnancy. Moreover, the sensitivity, specificity, positive and negative predictive values of the same pattern are computed to be 60.0, 95.7, 85.7 and 84.6%, respectively, in the prediction of ruptured tubal pregnancy.
Conclusions
Sonographic appearance of endometrium may be used to predict tubal pregnancy when ultrasonography shows no adnexal mass and maternal serum HCG ≤1,000 mIU/mL. That is, trilaminar pattern may indicate tubal pregnancy and warn about a possible related rupture in case of previous ectopic pregnancy or pelvic surgery. |
| doi_str_mv | 10.1007/s00404-009-1095-z |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_733840547</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>733840547</sourcerecordid><originalsourceid>FETCH-LOGICAL-c371t-a68ee812655d4a95831342e5b4b604dfd4c1d4a0ebf6af913f04a785c9f446083</originalsourceid><addsrcrecordid>eNp1kc1q3DAUhUVoyEyTPEA3xdBFVk6ubP15FcrQtIGBbJK1kOXriQeP5EjyYubpq2EGAoUuhATnO-dedAj5RuGeAsiHCMCAlQBNSaHh5eGCLCmrqxIkpV_IEprjG4RckK8xbgFopZS4IgvaZJ_gakmmlXFF9M5vgpneB1ug6_wOUxjMWEwmJQyuaLHIFJow7ovBdYM1yYeizyfNbebQJj9l7xRw44yz-4x3RcDRJOzOTJinNAd8vCGXvRkj3p7va_L29Ot19adcv_x-Xv1cl7aWNJVGKERFK8F5x0zDVU1rViFvWSuAdX3HLM0CYNsL0ze07oEZqbhtesYEqPqa3J1yp-A_ZoxJ74ZocRyNQz9HLetaMeBMZvLHP-TWz8Hl5XRVCaqkVMAzRU-UDT7GgL2ewrAzYa8p6GMb-tSGzm3oYxv6kD3fz8lzu8Pu03H-_gxUJyBmyW0wfI7-f-pfMLyWMw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2261877805</pqid></control><display><type>article</type><title>Can sonographic endometrial pattern be an early indicator for tubal ectopic pregnancy and related tubal rupture?</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Col-Madendag, Ilknur ; Madendag, Yusuf ; Kanat-Pektas, Mine ; Danisman, Nuri</creator><creatorcontrib>Col-Madendag, Ilknur ; Madendag, Yusuf ; Kanat-Pektas, Mine ; Danisman, Nuri</creatorcontrib><description>Purpose
The present study aims to determine whether sonographic endometrial pattern can be addressed as an early indicator for tubal ectopic pregnancy and related tubal rupture in case ultrasonography reveals no adnexal mass and maternal serum beta human chorionic gonadotropin (HCG) level is below the discriminatory zone (≤1,000 mIU/mL).
Methods
The study evaluated the endometrial features of 441 naturally conceived and asymptomatic first trimester (99 tubal ectopic, 138 failing and 264 normal intrauterine) with maternal serum beta HCG levels ≤1,000 mIU/mL and indeterminate sonographic findings.
Results
Tubal ectopic, failing intrauterine and normal intrauterine pregnancies are statistically similar in aspect of endometrial thickness. However, trilaminar endometrial pattern was significantly less frequent in failing and normal intrauterine pregnancies but significantly more frequent in ruptured tubal pregnancies. Also the relative risk of tubal rupture is significantly higher in case of trilaminar endometrial pattern. Trilaminar endometrial pattern has a sensitivity of 21.2%, specificity of 93.9%, positive predictive value of 50.0% and negative predictive value of 80.5% for distinguishing tubal ectopic pregnancy. Moreover, the sensitivity, specificity, positive and negative predictive values of the same pattern are computed to be 60.0, 95.7, 85.7 and 84.6%, respectively, in the prediction of ruptured tubal pregnancy.
Conclusions
Sonographic appearance of endometrium may be used to predict tubal pregnancy when ultrasonography shows no adnexal mass and maternal serum HCG ≤1,000 mIU/mL. That is, trilaminar pattern may indicate tubal pregnancy and warn about a possible related rupture in case of previous ectopic pregnancy or pelvic surgery.</description><identifier>ISSN: 0932-0067</identifier><identifier>EISSN: 1432-0711</identifier><identifier>DOI: 10.1007/s00404-009-1095-z</identifier><identifier>PMID: 19404658</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Adult ; Chorionic Gonadotropin, beta Subunit, Human - blood ; Endocrinology ; Endometrium - diagnostic imaging ; Female ; Gynecology ; Health risk assessment ; Human Genetics ; Humans ; Medicine ; Medicine & Public Health ; Obstetrics/Perinatology/Midwifery ; Original Article ; Pregnancy ; Pregnancy complications ; Pregnancy, Tubal - blood ; Pregnancy, Tubal - diagnostic imaging ; Reproducibility of Results ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity ; Ultrasonic imaging ; Ultrasonography ; Young Adult</subject><ispartof>Archives of gynecology and obstetrics, 2010-02, Vol.281 (2), p.189-194</ispartof><rights>Springer-Verlag 2009</rights><rights>Archives of Gynecology and Obstetrics is a copyright of Springer, (2009). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c371t-a68ee812655d4a95831342e5b4b604dfd4c1d4a0ebf6af913f04a785c9f446083</citedby><cites>FETCH-LOGICAL-c371t-a68ee812655d4a95831342e5b4b604dfd4c1d4a0ebf6af913f04a785c9f446083</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00404-009-1095-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00404-009-1095-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19404658$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Col-Madendag, Ilknur</creatorcontrib><creatorcontrib>Madendag, Yusuf</creatorcontrib><creatorcontrib>Kanat-Pektas, Mine</creatorcontrib><creatorcontrib>Danisman, Nuri</creatorcontrib><title>Can sonographic endometrial pattern be an early indicator for tubal ectopic pregnancy and related tubal rupture?</title><title>Archives of gynecology and obstetrics</title><addtitle>Arch Gynecol Obstet</addtitle><addtitle>Arch Gynecol Obstet</addtitle><description>Purpose
The present study aims to determine whether sonographic endometrial pattern can be addressed as an early indicator for tubal ectopic pregnancy and related tubal rupture in case ultrasonography reveals no adnexal mass and maternal serum beta human chorionic gonadotropin (HCG) level is below the discriminatory zone (≤1,000 mIU/mL).
Methods
The study evaluated the endometrial features of 441 naturally conceived and asymptomatic first trimester (99 tubal ectopic, 138 failing and 264 normal intrauterine) with maternal serum beta HCG levels ≤1,000 mIU/mL and indeterminate sonographic findings.
Results
Tubal ectopic, failing intrauterine and normal intrauterine pregnancies are statistically similar in aspect of endometrial thickness. However, trilaminar endometrial pattern was significantly less frequent in failing and normal intrauterine pregnancies but significantly more frequent in ruptured tubal pregnancies. Also the relative risk of tubal rupture is significantly higher in case of trilaminar endometrial pattern. Trilaminar endometrial pattern has a sensitivity of 21.2%, specificity of 93.9%, positive predictive value of 50.0% and negative predictive value of 80.5% for distinguishing tubal ectopic pregnancy. Moreover, the sensitivity, specificity, positive and negative predictive values of the same pattern are computed to be 60.0, 95.7, 85.7 and 84.6%, respectively, in the prediction of ruptured tubal pregnancy.
Conclusions
Sonographic appearance of endometrium may be used to predict tubal pregnancy when ultrasonography shows no adnexal mass and maternal serum HCG ≤1,000 mIU/mL. That is, trilaminar pattern may indicate tubal pregnancy and warn about a possible related rupture in case of previous ectopic pregnancy or pelvic surgery.</description><subject>Adult</subject><subject>Chorionic Gonadotropin, beta Subunit, Human - blood</subject><subject>Endocrinology</subject><subject>Endometrium - diagnostic imaging</subject><subject>Female</subject><subject>Gynecology</subject><subject>Health risk assessment</subject><subject>Human Genetics</subject><subject>Humans</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Obstetrics/Perinatology/Midwifery</subject><subject>Original Article</subject><subject>Pregnancy</subject><subject>Pregnancy complications</subject><subject>Pregnancy, Tubal - blood</subject><subject>Pregnancy, Tubal - diagnostic imaging</subject><subject>Reproducibility of Results</subject><subject>Retrospective Studies</subject><subject>ROC Curve</subject><subject>Sensitivity and Specificity</subject><subject>Ultrasonic imaging</subject><subject>Ultrasonography</subject><subject>Young Adult</subject><issn>0932-0067</issn><issn>1432-0711</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kc1q3DAUhUVoyEyTPEA3xdBFVk6ubP15FcrQtIGBbJK1kOXriQeP5EjyYubpq2EGAoUuhATnO-dedAj5RuGeAsiHCMCAlQBNSaHh5eGCLCmrqxIkpV_IEprjG4RckK8xbgFopZS4IgvaZJ_gakmmlXFF9M5vgpneB1ug6_wOUxjMWEwmJQyuaLHIFJow7ovBdYM1yYeizyfNbebQJj9l7xRw44yz-4x3RcDRJOzOTJinNAd8vCGXvRkj3p7va_L29Ot19adcv_x-Xv1cl7aWNJVGKERFK8F5x0zDVU1rViFvWSuAdX3HLM0CYNsL0ze07oEZqbhtesYEqPqa3J1yp-A_ZoxJ74ZocRyNQz9HLetaMeBMZvLHP-TWz8Hl5XRVCaqkVMAzRU-UDT7GgL2ewrAzYa8p6GMb-tSGzm3oYxv6kD3fz8lzu8Pu03H-_gxUJyBmyW0wfI7-f-pfMLyWMw</recordid><startdate>20100201</startdate><enddate>20100201</enddate><creator>Col-Madendag, Ilknur</creator><creator>Madendag, Yusuf</creator><creator>Kanat-Pektas, Mine</creator><creator>Danisman, Nuri</creator><general>Springer-Verlag</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20100201</creationdate><title>Can sonographic endometrial pattern be an early indicator for tubal ectopic pregnancy and related tubal rupture?</title><author>Col-Madendag, Ilknur ; Madendag, Yusuf ; Kanat-Pektas, Mine ; Danisman, Nuri</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c371t-a68ee812655d4a95831342e5b4b604dfd4c1d4a0ebf6af913f04a785c9f446083</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adult</topic><topic>Chorionic Gonadotropin, beta Subunit, Human - blood</topic><topic>Endocrinology</topic><topic>Endometrium - diagnostic imaging</topic><topic>Female</topic><topic>Gynecology</topic><topic>Health risk assessment</topic><topic>Human Genetics</topic><topic>Humans</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Obstetrics/Perinatology/Midwifery</topic><topic>Original Article</topic><topic>Pregnancy</topic><topic>Pregnancy complications</topic><topic>Pregnancy, Tubal - blood</topic><topic>Pregnancy, Tubal - diagnostic imaging</topic><topic>Reproducibility of Results</topic><topic>Retrospective Studies</topic><topic>ROC Curve</topic><topic>Sensitivity and Specificity</topic><topic>Ultrasonic imaging</topic><topic>Ultrasonography</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Col-Madendag, Ilknur</creatorcontrib><creatorcontrib>Madendag, Yusuf</creatorcontrib><creatorcontrib>Kanat-Pektas, Mine</creatorcontrib><creatorcontrib>Danisman, Nuri</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of gynecology and obstetrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Col-Madendag, Ilknur</au><au>Madendag, Yusuf</au><au>Kanat-Pektas, Mine</au><au>Danisman, Nuri</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Can sonographic endometrial pattern be an early indicator for tubal ectopic pregnancy and related tubal rupture?</atitle><jtitle>Archives of gynecology and obstetrics</jtitle><stitle>Arch Gynecol Obstet</stitle><addtitle>Arch Gynecol Obstet</addtitle><date>2010-02-01</date><risdate>2010</risdate><volume>281</volume><issue>2</issue><spage>189</spage><epage>194</epage><pages>189-194</pages><issn>0932-0067</issn><eissn>1432-0711</eissn><abstract>Purpose
The present study aims to determine whether sonographic endometrial pattern can be addressed as an early indicator for tubal ectopic pregnancy and related tubal rupture in case ultrasonography reveals no adnexal mass and maternal serum beta human chorionic gonadotropin (HCG) level is below the discriminatory zone (≤1,000 mIU/mL).
Methods
The study evaluated the endometrial features of 441 naturally conceived and asymptomatic first trimester (99 tubal ectopic, 138 failing and 264 normal intrauterine) with maternal serum beta HCG levels ≤1,000 mIU/mL and indeterminate sonographic findings.
Results
Tubal ectopic, failing intrauterine and normal intrauterine pregnancies are statistically similar in aspect of endometrial thickness. However, trilaminar endometrial pattern was significantly less frequent in failing and normal intrauterine pregnancies but significantly more frequent in ruptured tubal pregnancies. Also the relative risk of tubal rupture is significantly higher in case of trilaminar endometrial pattern. Trilaminar endometrial pattern has a sensitivity of 21.2%, specificity of 93.9%, positive predictive value of 50.0% and negative predictive value of 80.5% for distinguishing tubal ectopic pregnancy. Moreover, the sensitivity, specificity, positive and negative predictive values of the same pattern are computed to be 60.0, 95.7, 85.7 and 84.6%, respectively, in the prediction of ruptured tubal pregnancy.
Conclusions
Sonographic appearance of endometrium may be used to predict tubal pregnancy when ultrasonography shows no adnexal mass and maternal serum HCG ≤1,000 mIU/mL. That is, trilaminar pattern may indicate tubal pregnancy and warn about a possible related rupture in case of previous ectopic pregnancy or pelvic surgery.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>19404658</pmid><doi>10.1007/s00404-009-1095-z</doi><tpages>6</tpages></addata></record> |
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| identifier | ISSN: 0932-0067 |
| ispartof | Archives of gynecology and obstetrics, 2010-02, Vol.281 (2), p.189-194 |
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| language | eng |
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| subjects | Adult Chorionic Gonadotropin, beta Subunit, Human - blood Endocrinology Endometrium - diagnostic imaging Female Gynecology Health risk assessment Human Genetics Humans Medicine Medicine & Public Health Obstetrics/Perinatology/Midwifery Original Article Pregnancy Pregnancy complications Pregnancy, Tubal - blood Pregnancy, Tubal - diagnostic imaging Reproducibility of Results Retrospective Studies ROC Curve Sensitivity and Specificity Ultrasonic imaging Ultrasonography Young Adult |
| title | Can sonographic endometrial pattern be an early indicator for tubal ectopic pregnancy and related tubal rupture? |
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