Ectopic pregnancy in the ultrasound. Case reports. Retrospektive analysis


Authors: A. Derbak
Authors‘ workplace: Gynekologicko-porodnické oddělení Nemocnice Jindřichův Hradec, a. s. primář MUDr. J. Štětka
Published in: Čes. Gynek.2016, 81, č. 1 s. 63-70

Overview

Objective:
To evaluate the ultrasound findings of ectopic pregnancy in the group of women examined in our department transvaginal ultrasound. Analysis of ectopic pregnancy cases covers the period from 1. 8. 2012. to 31. 9. 2015. We introduced several case studies.

Design:
Retrospective analysis.

Setting:
Department of Gynecology and Obstetrics, Hospital Jindrichuv Hradec.

Methods:
The methodology is based on a retrospective evaluation of the history, laboratory and ultrasound findings in a group of 30 patients with ectopic pregnancy.

Results:
At the first visit were diagnosed by transvaginal ultrasound 82% ectopic pregnancy. A patological adnexal mass was visualised in 84% cases. A negative ultrasound finding was observed in 16% cases. The results of our group of patients are more or less comparable with other studies. We recorded the same risk factors for ectopic pregnancy.

Conclusion:
Most ectopic pregnancies can be diagnosed at the first examination before starting treatment and treated at an early stage. Transvaginal ultrasound is the “gold standard” diagnostic tool of choice in the diagnosis of ectopic pregnancy in combination with the dynamics of serum levels β-hCG..

KEYWORDS:
ectopic pregnancy, diagnostics, transvaginal ultrasound examination, β-hCG


Sources

1. Allahyar Jazayeri, MD. Surgical management of ectopic pregnancy. Medline, 2015 Feb.

2. American College of Obstetricians and Gynecologists (ACOG). ACOG Practice Bulletin No. 101: Ultrasonography in pregnancy. Obstet Gynecol, 2009, 113(2 Pt 1), p. 451–461.

3. Bouyer, J., Coste, J., Fernandez, H., et al. Sites of ectopic pregnancy: a 10 year population-based study of 1800 cases. Hum Reprod, 2002, 17(12), p. 3224–3230.

4. Bouyer, J., Coste, J., Shojaei, T., et al. Risk factors for ectopic pregnancy: a comprehensive analysis based on a large case-control, population-based study in France. Am J Epidemiol, 2003, 157(3), p. 185–194.

5. Buckley, RG., King, KJ. Serum progesterone testing to predict ectopic pregnancy in symptomatic first-trimester patients. Ann Emerg Med, 2000, 36, p. 95–100.

6. Casikar, I., Reid, S., Condous, G. Ectopic pregnancy: Ultrasound diagnosis in modern management. Clin Obstet Gynec, 2012, 55 (2), p. 402–409.

7. Farquhar, CM. Ectopic pregnancy. Lancet, 2005, 366(9485), p. 583–591.

8. Fischerová, D., Pašková, A., Břeťák, M. Těhotenství neznámé lokalizace. In Calda, P., Břešt’ák, M., Fischerová, D. Ultrazvuková diagnostika v těhotenství a gynekologii. 2. vyd. Praha, Aprofema, 2010, s. 428–434. ISBH 978-80-903706-2-3.

9. Kirk, E., Papageorghiou, A., Condous, G., et al. The diagnostic effectiveness of an initial transvaginal scan in detecting ectopic pregnancy. Hum Reprod, 2007, 22, 11, p. 2824–2828.

10. Kirk, E., Condous, G., Borune, T. Pregnancies of unkown location. Best Practice Res Clin Obstet Gynaecol, 2009, 23, p. 493–499.

11. Kirk, E. Ultrasound in the diagnosis of ectopic pregnancy. Clin Obstet Gynec, 2012, 55, 2, p. 395–401.

12. Kubešová, B., Líbalová, P., Simonová, V., et al. Retrospektivní analýza efektivity , diagnostiky ektopické gravidity transvaginálním ultrazvukovým vyšetřením. Čes Gynek, 2013, 78, 4, s. 338–341.

13. Kučera, E. Komentář ke článku Anne−Marie Lozeau, MD, Beth Potter, MD. Diagnostika a léčba mimoděložního těhotenství. Medical Tribune cz. Gynek po promoci, 2006, 4.

14. Goldman, GA., Fish, B., Ovadia, J., Tadir, Y. Heterotopic pregnancy after assisted reproductive technologies. Obstet Gynecol Surv, 1992, p. 217–221.

15. Gracia, CR., Barnhart, KT. Diagnosing ectopic pregnancy: decision analysis comparing six strategies. Obstet Gynecol, 2001, 97, p. 464–470.

16. Hajenius, PJ., Mol, F., Mol, BW., et al. Interventions for tubal ectopic pregnancy. Cochrane Database Syst Rev. 2007; CD000324.

17. Kadar, N., Bohrer, M., Kemmann, E., Shelden, R. The discriminatory human chorionic gonadotropin zone for endovaginal sonography: a prospective, randomized study. Fertil Steril, 1994, 61(6), p. 1016–1020.

18. Kolařík, D., Halaška, M., Feyereisl, J. Repetitorium gynekologie, 2. aktualizované vyd. Praha: Maxdorf, 2011. ISBN 978-80-7345-267-4.

19. Mol, BW., Van der Veen, F., Bossuyt, PM. Implementation of probabilistic decision rules improves the predictive values of algorithms in the diagnostic management of ectopic pregnancy. Hum Reprod, 1999, 14, p. 2855–2862.

20. Peterson, HB., Xia, Z., Hughes, JM., et al. The risk of pregnancy after tubal sterilization: finding from the US Collaborative review of sterilization. Am J Obstet Gynecol, 1996, 174, p. 1161–1168.

21. Shalev, E., Peleg, D., Tsabari, A., et al. Spontaneous resolution of ectopic tubal pregnancy: natural history. Fertil Steril, 1995, 63, p. 15–19.

22. Stein, JC., Wang, R., Adler, N., et al. Emergency physician ultrasonography for evaluating patients at risk for ectopic pregnancy: a meta-analysis. Ann Emerg Med, 2010, 56(6), p. 674–683.

23. Sun, SY., Araujo Júnior, E., Elito Júnior, J., et al. Diagnosis of heterotopic pregnancy using ultrasound and magnetic resonance imaging in the first trimester of pregnancy: a case report. Case Rep Radiol, 2012, p. 317592.

24. Tanaka, T., Hayashi, H., Kutsuzawa, T., et al. Treatment of interstitial ectopic pregnancy with methotrexate: report of a successful case. Fertil Steril, 1982, 37, p. 851–852.

25. Thoma, ME. Early detection of ectopic pregnancy visualising the presence of a tubal ring with ultrasonography. Am J Emerg Med, 2000, 18, p. 444–448.

26. ÚZIS ČR. Aktuální informace č. 9/2014.

27. Williams, S., Peipert, J., Buckel Zhao, Q., et al. Contraception and the risk of ectopic pregnancy. Contraception, 2014, 90(3), p. 326.

28. Wong, E., Suat, SO. Ectopic pregnancy: a diagnostic challenge in the emergency department. Eur J Emerg Med, 2000, 7(3), p. 189–194.

29. Zdeňková, A., Fanta, M., Calda, P. Metotrexát v léčbě ektopické gravidity. Actual Gyn, 2015, 7, p. 27–32.

Labels
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine

Article was published in

Czech Gynaecology

Issue 1

2016 Issue 1

Most read in this issue

This topic is also in:


Login
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account