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Can ultrasound reliably diagnose ectopic pregnancy?
Author(s) -
STABILE I.,
CAMPBELL S.,
GRUDZINSKAS J. G.
Publication year - 1988
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.1988.tb06813.x
Subject(s) - medicine , ectopic pregnancy , ultrasound , predictive value , pregnancy , predictive value of tests , obstetrics , positive predicative value , vaginal bleeding , gynecology , pelvic pain , radiology , genetics , biology
Summary. A total of 252 women with amenorrhoea and with abdominal pain or vaginal bleeding, or both, had an emergency high‐resolution ultrasound sector scan. In 100 women the symptoms were unrelated to any identifiable abnormal ultrasound rinding, none of them was pregnant and their symptoms settled spontaneously; 33 other women had follicular or luteal cysts and 30 had pelvic inflammatory disease, Histological examination confirmed an ectopic pregnancy in 60 women (24%); in seven a live fetus was observed outside the uterus allowing a confident diagnosis of ectopic pregnancy; in 27 the thickness of the endometrium was >10mm (sensitivity 50%, specificity 84%, positive predictive value 28%, negative predictive value 87%); in 15 the uterine area measurement was <20 cm 2 (sensitivity 72%, specificity 41 %, positive predictive value 20%, negative predictive value 79%); and 43 had an adnexal mass volume >10ml separate from the ovary (sensitivity 85%, specificity 37%, positive predictive value 23%, negative predictive value 90%). Only three had negative ultrasound findings. The negative predictive value of an ultrasound examination could be increased to 96% by using a combination of these ultrasound features. The addition of hCG (>25 i.u./l) improved the specificity to 98% and the negative predictive value to 100%. These criteria may improve the ultrasound diagnosis of ectopic pregnancy.