Reevaluating the role of dilation and curettage in the diagnosis of pregnancy of unknown location  

Oleh:

Chung, Karine ; Chandavarka, Uma ; Oppe, Neisha ; Barnhart, Kurt T.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Fertility and Sterility (keterangan: ada di ClinicalKey) vol. 96 no. 03 (Sep. 2011), page 659-662.
Topik: Ectopic pregnancy; dilation and curettage; methotrexate

Ketersediaan

Perpustakaan FK Nomor Panggil: F02.K.2011.01 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

Lihat Detail Induk

Isi artikel

Objective To evaluate the clinical utility of dilation and curettage (D&C) in diagnosing ectopic pregnancy (EP). Design Retrospective cohort study. Setting University hospital. Patient(s) Clinically stable women (n = 321) who underwent a diagnostic D&C with no visible intrauterine pregnancy (IUP) on transvaginal ultrasound or those with an abnormal hCG trend. Intervention(s) None. Main Outcome Measure(s) EP or IUP made by final pathologic review. Result(s) Overall, 73.2% of the patients were ultimately diagnosed with EP and 26.8% were found to have a nonviable IUP. Those with EPs had significantly lower initial hCGs than those with nonviable IUPs and were more likely to have had a history of an EP. On ultrasound, the overall impression, the presence of free fluid, and the endometrial echo complex correlated well with the final diagnoses but did not have 100% predictive value. Conclusion(s) D&C remains valuable to differentiate EP from nonviable IUP and to avoid misdiagnosis and unnecessary exposure to methotrexate. Low initial hCG values and ultrasound findings such as a thin endometrial echo complex and the presence of free fluid are associated with but are not diagnostic of an ectopic pregnancy.

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