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1
Department of Radiology, McGill University, Montreal General Hospital, 1650
Ave. Cedar, Montreal, Quebec H3G 1A4, Canada.
2
Present address: Department of Medical Imaging, University of Toronto,
Sunnybrook and Women's College Health Sciences Centre, 2075 Bayview Ave.,
Toronto, Ontario M3N 3M5, Canada.
3
Department of Epidemiology & Biostatistics, McGill University, 1020 Pine
Ave. W., Montreal, Quebec H3A 1A2, Canada.
4
Department of Obstetrics and Gynecology, McGill University, Montreal General
Hospital, Montreal, Quebec H3G 1A4, Canada.
5
Present address: Department of Medical Imaging, University of Toronto,
University Health Network and Mount Sinai Hospital, 610 University Ave.,
Toronto, Ontario M5G 2M9, Canada.
OBJECTIVE. We identified the potential clinical and sonographic predictors of the spontaneous resolution of ectopic pregnancies.
SUBJECTS AND METHODS. We performed a prospective study of 78 consecutive patients with a transvaginal sonographic diagnosis of ectopic pregnancy who had either two consecutive quantitative measurements of their beta subunit of human chorionic gonadotropin (ß-hCG) more than 24 hrs apart or an embryo with a heart beat. We evaluated the patient's age, time from the last menstrual period, ß-hCG level, size of ectopic pregnancy, presence of a gestational sac or embryonic elements, vascularity on color Doppler sonography, peak systolic velocity, and resistive index of ectopic pregnancy at the time of presentation as potential independent predictors of the final outcome. Logistic regression was performed to identify the independent predictors.
RESULTS. Forty-six patients had declining ß-hCG levels, and 32 ectopic pregnancies showed an embryo with a heart beat or had steady or rising ß-hCG levels. Univariate analysis indicated that a longer time from the last menstrual period (older ectopic pregnancies), lower ß-hCG levels, and the absence of gestational sac are statistically more significantly seen in ectopic pregnancies with declining ß-hCG levels (p < 0.05). Resistive index of ectopic pregnancy reached borderline significance (p = 0.05). In a multiple logistic model, the same variables were independent predictors of outcome (p < 0.05). Resistive index was also a predictor (p = 0.09).
CONCLUSION. Longer times from the last menstrual period, lower ß-hCG levels, absence of gestational sacs, and higher resistive indexes of ectopic pregnancy at the time of presentation appear to be independent predictors of the spontaneous resolution of ectopic pregnancy.
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