Expectant Treatment of Ectopic Pregnancies
| Autor: | Chi-Ming Chow, George Kintzen, Caroline Reinhold, Patrice M. Bret, Micheline Thibodeau, Ann Aldis, M Atri, Peter M. Gillett |
|---|---|
| Rok vydání: | 2001 |
| Předmět: |
Adult
medicine.medical_specialty Remission Spontaneous Gestational sac Extraembryonic Membranes Logistic regression Human chorionic gonadotropin Vascularity Predictive Value of Tests Pregnancy medicine Humans Chorionic Gonadotropin beta Subunit Human Radiology Nuclear Medicine and imaging Prospective Studies Ultrasonography Doppler Color Prospective cohort study Gynecology Ectopic pregnancy Obstetrics business.industry Gestational age General Medicine medicine.disease Pregnancy Ectopic Logistic Models medicine.anatomical_structure Female Vascular Resistance Presentation (obstetrics) medicine.symptom business Blood Flow Velocity |
| Zdroj: | American Journal of Roentgenology. 176:123-127 |
| ISSN: | 1546-3141 0361-803X |
| Popis: | We identified the potential clinical and sonographic predictors of the spontaneous resolution of ectopic pregnancies.We performed a prospective study of 78 consecutive patients with a transvaginal sonographic diagnosis of ectopic pregnancy who had either two consecutive quantitative measurements of their beta subunit of human chorionic gonadotropin (beta-hCG) more than 24 hrs apart or an embryo with a heart beat. We evaluated the patient's age, time from the last menstrual period, beta-hCG level, size of ectopic pregnancy, presence of a gestational sac or embryonic elements, vascularity on color Doppler sonography, peak systolic velocity, and resistive index of ectopic pregnancy at the time of presentation as potential independent predictors of the final outcome. Logistic regression was performed to identify the independent predictors.Forty-six patients had declining beta-hCG levels, and 32 ectopic pregnancies showed an embryo with a heart beat or had steady or rising beta-hCG levels. Univariate analysis indicated that a longer time from the last menstrual period (older ectopic pregnancies), lower beta-hCG levels, and the absence of gestational sac are statistically more significantly seen in ectopic pregnancies with declining beta-hCG levels (p0.05). Resistive index of ectopic pregnancy reached borderline significance (p = 0.05). In a multiple logistic model, the same variables were independent predictors of outcome (p0.05). Resistive index was also a predictor (p = 0.09).Longer times from the last menstrual period, lower beta-hCG levels, absence of gestational sacs, and higher resistive indexes of ectopic pregnancy at the time of presentation appear to be independent predictors of the spontaneous resolution of ectopic pregnancy. |
| Databáze: | OpenAIRE |
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