6533b7dbfe1ef96bd126f7fa

RESEARCH PRODUCT

Does transvaginal color Doppler sonography differentiate between developing and involuting ectopic pregnancies?

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The objective of this study was to assess the addition of transvaginal color Doppler imaging to transvaginal ultrasonography and beta-human chorionic gonadotropin values to differentiate between developin and involuting ectopic pregnancies. Forty surgically confirmed ectopic pregnancies were classified into developing or involuting according to histopathologic findings. Results were compared retrospectively with the plasma beta-human chorionic gonadotropin values as well as the resistive index and pulsatility index obtained in corpora lutea and peritrophoblastic flow in serial examinations. Student's t-test was used for comparison of means. Logistic regression analysis was applied to predict the binary dependent variable in women with a developing or involuting ectopic pregnancy by analyzing a set of independent variables, serum betahuman chorionic gonadotropin levels, and resistive and pulsatility indices of corpora lutea and adnexal masses. Twenty-seven ectopic pregnancies were developing and 13 were involuting. The women with developing ectopic pregnancies had significantly higher serum levels of beta-human chorionic gonadotropin than those with involuting ectopic pregnancies (P<0.05). Furthermore, women with developing ectopic pregnancies showed a 15 to 20% decrease in the resistive index and pulsatility index baseline every four days. In contrast, we were unable to distinguish between developing and involuting ectopic pregnancies by analyzing beta-human chorionic gonadotropin values at this early stage of gestation. The logistic regression model showed that a corpus luteum resistive index increase was the only marker that predicted involution of an ectopic pregnancy before day 49. Similarly, after day 49 an increase in tubal mass resistive index was the only parameter that consistently identifies an involuting tubal ectopic pregnancy. Our observations demonstrate that adnexal flow mapping with transvaginal color Doppler sonography can detect developing and involuting tubal ectopic pregnancies. Until the 49th day, an increase in corpus luteum resistive and pulsatility indices identifies an involuting ectopic pregnancy. After the 49th day, an increase in tubal mass resistive and pulsatility indices identifies an involuting ectopic pregnancy rotropin