Abstract
Objective
To re-evaluate the role of measuring endometrial thickness (ET) in prediction of intrauterine
pregnancy (IUP) among women with pregnancy of unknown location (PUL).
Study design
987 women with PUL were included in a prospective observational multicenter study.
Transvaginal ultrasonography was performed to measure ET and a blood sample was taken
to measure serum β-hCG and progesterone levels. All patients were then managed expectantly
till the final PUL outcome was diagnosed.
Results
78 patients (8.9%) were finally diagnosed as having IUP. The best cutoff point of
ET as a possible predictor for IUP was 10 mm, with an area under receiver-operating characteristic (ROC) curve of 69.0%. At
this cutoff point, ET was able to predict IUP with positive likelihood ratio (PLR)
and negative likelihood ratio (NLR) of 1.43 and 0.19, respectively. Serum progesterone
at a cutoff point of 50 nmol/L was able to predict IUP with PLR and NLR of 9.0 and 0.06, respectively. Variables
showing statistically significant differences among those with IUP and those with
the other PUL outcomes using univariate analysis (ET, gestational age, β-hCG, parity,
serum progesterone and maternal age) were entered into logistic regression analysis.
Logistic regression models were constructed. The performance of these models was better
than using ET alone to predict the outcome of PUL.
Conclusion
Measurement of ET is not recommended as a single clinical test for intrauterine pregnancy
prediction in women with pregnancy of unknown location.
Key words
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Article info
Publication history
Published online: January 17, 2013
Accepted:
December 29,
2012
Received in revised form:
December 6,
2012
Received:
July 3,
2012
Footnotes
☆Setting: Multicenter study (Early Pregnancy Assessment Units of 3 large governmental hospitals in 3 different regions in Saudi Arabia; eastern, northern and southern regions).
Identification
Copyright
© 2013 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
