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Endometrial stripe thickness and pregnancy outcome in first-trimester pregnancies with bleeding, pain or both
Beata Seeber1, Mary Sammel, Lan Zhou
1Department of Obstetrics and Gynecology, University of Pennsylvania Medical Center, Philadelphia 19104, USA.
Objective:
To determine the association between endometrial stripe (ES) thickness and pregnancy outcome in women with a symptomatic first-trimester pregnancy and to determine how vaginal bleeding, pelvic pain and 1 human chorionic gonadotropin (hCG) level affect ES thickness.
Study Design:
Data on ES thickness, serum hCG, presence of pain, characterization of vaginal bleeding and ultimate clinical outcome were collected for 576 women presenting to the emergency room.
Results:
ES was thinner with increased vaginal bleeding and associated with hCG level and pregnancy outcome. The mean ES for ectopic pregnancies (EPs) was 9.56 +/- 4.87, for intrauterine pregnancies was 12.12 +/- 6.0 and for spontaneous abortion was 10.19 +/- 6.10. Ninety-nine percent of patients with EP had an ES <21 mm, and 100% had one < or =25 mm.
Conclusion:
There was considerable overlap in ES for the 3 pregnancy outcomes, making it a poor diagnostic test. Nevertheless, ES >21 mm in a woman with no evidence of a gestational sac excludes EP with 96% specificity. A patient with a stripe >25 mm may be expectantly managed.
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