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Outcome prediction in pregnancies of unknown location using endometrial thickness measurement: is this of real clinical value?

  • Author Footnotes
    1 All authors have contributed significantly and are responsible for the content of this manuscript.
    Mohamed Ellaithy
    Correspondence
    Corresponding author at: Building 14, Block 14, Alwaha District, Nasr City, Cairo, Egypt. Tel.: +201 006873417.
    Footnotes
    1 All authors have contributed significantly and are responsible for the content of this manuscript.
    Affiliations
    Obstetrics & Gynecology Department, Ain Shams Faculty of Medicine, Cairo, Egypt
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  • Author Footnotes
    1 All authors have contributed significantly and are responsible for the content of this manuscript.
    Ahmed Abdelaziz
    Footnotes
    1 All authors have contributed significantly and are responsible for the content of this manuscript.
    Affiliations
    Obstetrics & Gynecology Department, Ain Shams Faculty of Medicine, Cairo, Egypt
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  • Author Footnotes
    1 All authors have contributed significantly and are responsible for the content of this manuscript.
    Mahmoud Fathy Hassan
    Footnotes
    1 All authors have contributed significantly and are responsible for the content of this manuscript.
    Affiliations
    Obstetrics & Gynecology Department, Ain Shams Faculty of Medicine, Cairo, Egypt
    Search for articles by this author
  • Author Footnotes
    1 All authors have contributed significantly and are responsible for the content of this manuscript.
Published:January 17, 2013DOI:https://doi.org/10.1016/j.ejogrb.2012.12.026

      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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