Abstract
Previous studies have regarded the discriminatory serum β-hCG zone (DSZ) as a valuable tool for the diagnosis of ectopic pregnancy (EP). However, the wide range of the DSZ makes achieving a clinical diagnosis of EP difficult, and these reports do not indicate whether the DSZ is suitable for an EP diagnosis in Chinese women. Several studies have indicated that the endometrial pattern in patients with EPs is different from that in patients with intrauterine pregnancies (IUPs). The aims of this study were to define the DSZ cutoff value for Chinese women, test whether the endometrial pattern is a suitable predictor for EP, and assess the diagnostic value of these indicators. We enrolled participants with IUPs or EPs with abdominal pain and/or vaginal bleeding, and serum β-hCG level measurements and transvaginal ultrasound (TVS) were performed to assess the diagnostic value of the indicators for EP. The sensitivity and specificity for identifying an EP were improved by combining the DSZ, endometrial thickness and trilaminar pattern indexes. The results of this study might be helpful toward providing further options for the diagnosis of EP, especially for patients without hemoperitoneum or colporrhagia.
Highlights
Ectopic pregnancy (EP) is a common and potentially lethal emergency in the first trimester of pregnancy[1]
Several studies have shown that the endometrial thickness associated with ectopic pregnancy (EP) is much lower than that associated with intrauterine pregnancies (IUPs) and that EP might result in intracavitary fluid as well as trilaminar, homogeneous and heterogeneous patterns[10,11]
We evaluated the diagnostic value of a single index including the discriminatory serum β-hCG zone (DSZ), endometrial thickness and trilaminar pattern for EP by performing a receiver operating characteristics (ROC) curve analysis
Summary
Ectopic pregnancy (EP) is a common and potentially lethal emergency in the first trimester of pregnancy[1]. Our previous study showed that the ratio of the β-hCG level in the blood at the location of the pregnancy (hemoperitoneum or vaginal blood) to the β-hCG level in venous serum can be used as a diagnostic indicator of EP7,8. This method is not suitable for patients without hemoperitoneum or vaginal bleeding. Several diagnostic tests have been used to evaluate patients with suspected EP, including β-hCG measurements and transvaginal ultrasound (TVS). The wide range increases the difficulty in achieving a clinical diagnosis, and it is unclear whether the DMZ is suitable for Chinese women
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