Can Transvaginal Sonography Promotes Management of Pregnancy of Unknown Location (PUL) and Reduces Number of ?HCG test? - Abstract
Introduction: The management of women with pregnancy of unknown location (PUL), can vary significantly and often lacks a clear evidence base. This study aims to improve the diagnosis and management of PUL by evaluating ultrasound images using specific criteria describing the gestation sac.
Method: Retrospective study. Data collected from the medical records for pregnant patients at initial visit to EPU. Data underwent specific ultrasound image criteria in reporting empty GS and describing deciduae signs.
Result: A total of 69 cases were reviewed and 68 showed empty GS in the initial visit. There were three reports that described GS with DD signs sufficiently. After the image review process, GS DD signs were noted in 25 (69%), cases, one DD sign in 12 (85%), whilst 4 (44%), cases did not demonstrate any DD signs. Moreover, the sensitivity rate of the presence of DD signs and viability as the final outcome was 87.5% whereas specificity was 22.2%.
Conclusion: A well written ultrasound report considering specific criteria in describing intrauterine sac would help in decreasing numbers of PUL from initial visits and subsequently reduce the number of un-necessary laparoscopy and ?HCG tests.