Quantifying the risk of ectopic pregnancy with a transient diagnosis of pregnancy of unknown location

医学 异位妊娠 产科 怀孕 回顾性队列研究 人口 优势比 妇科 阴道出血 逻辑回归 外科 内科学 遗传学 环境卫生 生物
作者
Dhanalakshmi Thiyagarajan,Quetzal A. Class,Mary D. Stephenson
出处
期刊:International journal of gynaecology and obstetrics [Elsevier BV]
卷期号:162 (3): 950-956 被引量:1
标识
DOI:10.1002/ijgo.14784
摘要

To quantify the risk of ectopic pregnancy among a transient diagnosis of pregnancy of unknown location (PUL).Retrospective cohort study between August 2016 and November 2020. The final cohort included 244 patients with 255 PULs who presented with vaginal bleeding and/or abdominal pain, positive serum quantitative β-human chorionic gonadotropin, and negative transvaginal ultrasound, with a subsequent definitive diagnosis. Two-way analysis of variance was used with significance set at P < 0.050. Bonferroni-corrected significance values were used in post hoc analysis. Multinominal logistic regression was used to predict adjusted risk for pregnancy outcome.Definitive diagnosis consisted of 101 (39%) intrauterine pregnancies, 33 (13%) ectopic pregnancies, and 121 (48%) resolved PULs or resolved/treated persisting PULs. A total 68% of the PULs subsequently became nonviable. Vaginal bleeding was associated with increased risk of nonuterine pregnancies.A total of 13% of PULs were subsequently diagnosed as ectopic pregnancies, which is higher than the 2% to 3% risk of an ectopic pregnancy in the general reproductive population. A total of 68% of PULs were subsequently nonviable, which is higher than the 31% early pregnancy loss rate in the general reproductive population. This study quantitatively confirms that a transient diagnosis of a PUL increases the odds for ectopic pregnancy and early pregnancy loss.
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