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Sonographic endometrial three‐layer pattern in symptomatic first‐trimester pregnancy: Not diagnostic of ectopic pregnancy
Author(s) -
Wachsberg Ronald H.,
Karimi Sasan
Publication year - 1998
Publication title -
journal of clinical ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.272
H-Index - 61
eISSN - 1097-0096
pISSN - 0091-2751
DOI - 10.1002/(sici)1097-0096(199805)26:4<199::aid-jcu4>3.0.co;2-8
Subject(s) - medicine , ectopic pregnancy , pregnancy , obstetrics , gynecology , first trimester , gestation , genetics , biology
Purpose We evaluated a recent report that suggested that a “3‐layer” appearance of the endometrium on sonography is diagnostic of ectopic pregnancy in symptomatic pregnant patients. Methods We reviewed the log of pelvic sonograms performed to rule out ectopic pregnancy in women presenting with first‐trimester bleeding and/or pain during a 29‐month period. Medical records and sonograms of patients without sonographic evidence of intrauterine pregnancy were reviewed to determine final diagnoses and whether the 3‐layer pattern was present. Results One hundred twenty patients with available follow‐up had no sonographic evidence of intrauterine pregnancy. Fifty‐nine (49%) had ectopic pregnancy. An endometrial 3‐layer pattern was noted sonographically in 15 patients (13%), of whom 6 (40%) had ectopic pregnancy. As a diagnostic sign of ectopic pregnancy, the endometrial 3‐layer pattern had a sensitivity of 10.2%, specificity of 85.2%, positive predictive value of 40%, negative predictive value of 50.5%, and accuracy of 49.2%. Conclusions The endometrial 3‐layer pattern is neither sensitive nor specific for the diagnosis of ectopic pregnancy. © 1998 John Wiley & Sons, Inc. J Clin Ultrasound 26:199–201, 1998.