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Endometrial color flow/image-directed Doppler imaging: negative predictive value for excluding ectopic pregnancy
T J Dubinsky1, H R Parvey, N Maklad
1Department of Radiology, University of Texas-Houston, LBJ General Hospital, Houston 77026, USA.
Journal of Clinical Ultrasound : JCU
|March 1, 1997
Summary
Endometrial arterial blood flow detected via transvaginal ultrasound significantly reduces the likelihood of ectopic pregnancy. Venous flow, however, does not reliably exclude this condition.
Area of Science:
- Reproductive medicine
- Diagnostic imaging
- Gynecologic oncology
Background:
- Transvaginal ultrasound is crucial for diagnosing intrauterine pregnancies and virtually excluding ectopic pregnancies.
- However, specific endometrial findings that may indicate a lower risk for ectopic pregnancy require further investigation.
Purpose of the Study:
- To prospectively evaluate the predictive value of endometrial blood flow, assessed by transvaginal color flow/image-directed Doppler imaging, in excluding ectopic pregnancy.
Main Methods:
- 211 women underwent transvaginal ultrasound with endometrial Doppler imaging to exclude ectopic pregnancy.
- Flow presence was confirmed by Doppler signal within the endometrium.
- Resistive indices and peak systolic velocity were analyzed; findings correlated with surgical and pathology results.
Main Results:
- Ectopic pregnancies occurred in 55 patients; 9 showed endometrial blood flow (3 arterial, 6 venous).
- Among 156 non-ectopic pregnancies, 107 had endometrial arterial blood flow.
- Endometrial arterial blood flow demonstrated a 97% negative predictive value for excluding ectopic pregnancy.
Conclusions:
- The presence of arterial blood flow within the endometrium is a significant indicator for lowering the risk of ectopic pregnancy.
- Endometrial venous blood flow does not reliably exclude the possibility of an ectopic pregnancy.