Sonographic endometrial three-layer pattern in symptomatic first-trimester pregnancy: Not diagnostic of ectopic pregnancy
✍ Scribed by Wachsberg, Ronald H.; Karimi, Sasan
- Publisher
- John Wiley and Sons
- Year
- 1998
- Tongue
- English
- Weight
- 68 KB
- Volume
- 26
- Category
- Article
- ISSN
- 0091-2751
No coin nor oath required. For personal study only.
✦ Synopsis
Purpose. We evaluated a recent report that suggested that a ''3-layer'' appearance of the endometrium on sonography is diagnostic of ectopic pregnancy in symptomatic pregnant patients.
Methods. We reviewed the log of pelvic sonograms performed to rule out ectopic pregnancy in women presenting with first-trimester bleeding and/or pain during a 29-month period. Medical records and sonograms of patients without sonographic evidence of intrauterine pregnancy were reviewed to determine final diagnoses and whether the 3-layer pattern was present.
Results. One hundred twenty patients with available follow-up had no sonographic evidence of intrauterine pregnancy. Fifty-nine (49%) had ectopic pregnancy. An endometrial 3-layer pattern was noted sonographically in 15 patients (13%), of whom 6 (40%) had ectopic pregnancy. As a diagnostic sign of ectopic pregnancy, the endometrial 3-layer pattern had a sensitivity of 10.2%, specificity of 85.2%, positive predictive value of 40%, negative predictive value of 50.5%, and accuracy of 49.2%.
Conclusions. The endometrial 3-layer pattern is neither sensitive nor specific for the diagnosis of ectopic pregnancy.