[ENDOMETRIAL-PATTERN IN EARLY PREGNANCY AND CORRELATION WITH ECTOPIC-PREGNANCY]

Area of Science:

• Obstetrics and Gynecology
• Radiology
• Reproductive Medicine

Background:

• Ectopic pregnancy is a major cause of first-trimester maternal mortality.
• Current early diagnostic methods for ectopic pregnancy using ultrasound have limitations.
• There is a critical need for novel sonographic markers to improve early diagnosis.

Purpose of the Study:

• To evaluate the endometrial pattern on transvaginal ultrasound as an early diagnostic marker for ectopic pregnancy.
• To assess the utility of the endometrial pattern before the visualization of a tubal mass.

Main Methods:

• A multicenter prospective study involving 52 women with a positive hCG test and pregnancy of unknown location.
• Transvaginal ultrasound was performed, focusing on endometrial patterns (homogeneous, heterogeneous, three-laminar, fluid collection).

Main Results:

• Of 38 ectopic pregnancies, the three-laminar pattern showed a 94% positive predictive value and 42% sensitivity.
• The three-laminar pattern had 83% specificity and 18% negative predictive value for ectopic pregnancy.
• Endometrial pattern changes were observed during follow-up, including transitions to a homogeneous pattern.

Conclusions:

• Transvaginal ultrasound assessment of the endometrial pattern is a simple, expertise-independent method for early pregnancy evaluation.
• Identifying a three-laminar endometrial pattern in pregnancies of unknown location should increase suspicion for ectopic pregnancy.
• Further research is needed to explore dynamic endometrial pattern changes in early pregnancy.