P110: Transvaginal Color Doppler (TVCD) in evaluation of patients with positive Human Chorionic Gonadotropin (hCG) test (in excluded intrauterine pregnancy)

Abstract

Purpose: To determine the diagnostic role of TVCD in patients with positive hCG test in cases when intrauterine pregnancy is excluded. To definite the correlation of the TVCD findings with the level of hCG. Material and methods: 101 patients with positive hCG test were examined. These included: Ectopic pregnancy (EP-27.7%), recent spontaneous abortion (RSA-9.9%), molar pregnancy (MP-31.7%), hemorrhagic or ruptured corpus luteum cyst (OH/OR-14.9%), ovarian torsion (OT-15.8%). Results: The negative hCG test excluded developing EP. The exception was a chronic EP (17.7%), when the level of test was correlated with vascularity of the EP. In clinically suspected EP cases, when hCG >2000 mIU/mL and TVCD failed to disclose intrauterine gestational sac, the patient had an EP or RSA. When hCG <2000 mlU/ml, serial hCG test was performed (on 48 h. intervals) and the TVCD was repeated once the discriminatory level was reached. In cases of MP with ‘‘snow storm’’ sign, high vascularization and low RI/PI, a hCG was not decreased (uncommonly increased). After the MP extraction the abovementioned findings were correlated with hCG level. In cases of OH, OR, OT the increased level of hCG was not so significant, as clinical manifestation (pelvic pain) and TVCD findings. Conclusion: The TVCD has significant role in management of patients with positive hCG test.