经阴道超声检查发现子宫内膜腔内有强回声物质的患者不太可能有正常的宫内妊娠。

Normal intrauterine pregnancy is unlikely in patients who have echogenic material identified within the endometrial cavity at transvaginal ultrasonography.

作者信息

Dart R, Dart L, Mitchell P

机构信息

Department of Emergency Medicine, Boston Medical Center, MA 02118, USA.

出版信息

Acad Emerg Med. 1999 Feb;6(2):116-20. doi: 10.1111/j.1553-2712.1999.tb01047.x.

DOI:10.1111/j.1553-2712.1999.tb01047.x

PMID:10051902

Abstract

UNLABELLED

In first-trimester patients with abdominal pain or vaginal bleeding, pelvic ultrasonography (US) is often performed to assess the status of the pregnancy. Identification of echogenic material within the endometrial cavity in the absence of a gestational sac has been attributed to the presence of either retained products of conception or clotted blood. However, to the authors' knowledge, no study has directly addressed whether this finding reliably excludes the diagnosis of a normal intrauterine pregnancy (IUP).

OBJECTIVE

To determine whether the identification of echogenic material within the endometrial cavity at transvaginal US excludes the diagnosis of a normal IUP.

METHODS

Data were collected retrospectively from August 1991 to August 1997 on consecutive urban teaching hospital ED patients with abdominal pain or vaginal bleeding who had a transvaginal US performed during the ED visit that demonstrated echogenic material within the endometrial cavity. Patients were excluded if they had a dilatation and evacuation (D + E) procedure performed prior to the exclusion of a normal IUP by other means [open cervical os, falling quantitative beta--human chorionic gonadotropin (beta-hCG) values, a progesterone value < 5.0 ng/mL or beta-hCG > 3,000 mIU/mL] or if they were lost to follow-up. Patients were followed until a final diagnosis was ultimately determined.

RESULTS

A total of 83 patients with echogenic material were identified. Of these, three patients were excluded because a D + E was performed prior to an IUP being excluded by other means, and two patients were lost to follow-up. Of the 78 enrolled patients, none had a final diagnosis of normal IUP. Ectopic pregnancy was confirmed in nine patients, five of whom had no adnexal or cul de sac findings to suggest this diagnosis.

CONCLUSION

In symptomatic patients who have echogenic material but no gestational sac visualized within the endometrial cavity at US, the likelihood of a normal IUP is low.

摘要

未加标注

在孕早期出现腹痛或阴道出血的患者中，常进行盆腔超声检查（US）以评估妊娠状态。在没有妊娠囊的情况下，子宫内膜腔内出现强回声物质被认为是妊娠物残留或凝血块。然而，据作者所知，尚无研究直接探讨这一发现是否能可靠地排除正常宫内妊娠（IUP）的诊断。

目的

确定经阴道超声检查时子宫内膜腔内出现强回声物质是否能排除正常IUP的诊断。

方法

回顾性收集1991年8月至1997年8月期间城市教学医院急诊科连续收治的因腹痛或阴道出血在急诊科就诊时接受经阴道超声检查且显示子宫内膜腔内有强回声物质的患者的数据。如果患者在通过其他方法（宫颈口开放、定量β-人绒毛膜促性腺激素（β-hCG）值下降、孕酮值<5.0 ng/mL或β-hCG>3000 mIU/mL）排除正常IUP之前进行了刮宫术（D + E），或者失访，则将其排除。对患者进行随访，直至最终确定最终诊断。