Relationship Between Ultrasonographic and Biochemical Markers of Tubal Ectopic Pregnancy and Success of Subsequent Management
| العنوان: | Relationship Between Ultrasonographic and Biochemical Markers of Tubal Ectopic Pregnancy and Success of Subsequent Management |
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| المؤلفون: | B. Nadim, George Condous, Fernando Infante, Chuan Lu, Shannon Reid |
| المصدر: | Journal of Ultrasound in Medicine. 37:2899-2907 |
| بيانات النشر: | Wiley, 2018. |
| سنة النشر: | 2018 |
| مصطلحات موضوعية: | Adult, medicine.medical_specialty, Adolescent, Gestational sac, Ovary, Chorionic Gonadotropin, Ultrasonography, Prenatal, Human chorionic gonadotropin, Cohort Studies, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, medicine, Humans, Radiology, Nuclear Medicine and imaging, Prospective Studies, 030212 general & internal medicine, Yolk sac, Prospective cohort study, Biochemical markers, Gynecology, 030219 obstetrics & reproductive medicine, Radiological and Ultrasound Technology, business.industry, Tubal ectopic pregnancy, Pregnancy, Ectopic, medicine.anatomical_structure, Female, Methotrexate, business, medicine.drug |
| الوصف: | Objectives To determine whether there is an association between morphologic types of tubal ectopic pregnancy (EP), 0-hour human chorionic gonadotropin (hCG) levels, and subsequent management success. Methods We conducted a prospective study (November 2006-December 2015). Women had a diagnosis of EP by transvaginal ultrasonography if they had an inhomogeneous mass adjacent to the ovary and moving separately from it ("blob" sign), a mass with a hyperechoic ring around the gestational sac ("bagel" sign), or a gestational sac with an embryonic pole with or without a yolk sac with or without cardiac activity. The morphologic type, EP size, and 0-hour hCG level were analyzed. A multivariate analysis determined any correlation between these variables and nonsurgical management success. Results A total of 7350 consecutive women underwent transvaginal ultrasonography, of whom 301 (4.2%) had a diagnosis of tubal EP; 181 (60.1%) had the blob sign; 90 (29.9%) had the bagel sign; and 23 (7.6%) were noted to have an embryo (14 viable and 9 nonviable). Eighty-three of 301(27.5%) women had expectant management; 67 of 301(22.2%) were given methotrexate; and 151 of 301 (50%) had surgery. Success rates for the groups were 77%, 75%, and 100%, respectively. No difference between the morphologic type and success rate of treatment was noted. Although there was a significant correlation between the EP mass size and 0-hour hCG level, the mass size itself was not correlated with the success rate of either medical or expectant management. Overall higher 0-hour hCG levels were associated with management failure. In the expectant group, median hCG level for failure was 589 IU/L versus 366 IU/L for success, whereas in the medical group, the median for failure was 1244 IU/L versus 7629 IU/L for success. Conclusions There is no significant correlation between the morphologic type and size of EP with a nonsurgical management outcome. A likely successful outcome is related to a lower level of serum hCG at presentation. |
| تدمد: | 1550-9613 0278-4297 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::7332a4f2ae911fe335034b011a792768 https://doi.org/10.1002/jum.14652 |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi.dedup.....7332a4f2ae911fe335034b011a792768 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15509613 02784297 |
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