Malek-mellouli Monia, Oumara Maina, Ben Amara Fethi, Zouch Ons, Neji Khaled, Reziga Hédi
Department "B" of gynaecology and obstetrics, Center of maternity and neonatology, "La Rabata", Tunis, Tunisia.
Tunis Med. 2013 Jan;91(1):27-32.
Women having pregnancies of unknown location (PUL) can be defined as those having positive pregnancy test when no pregnancy is visualized on transvaginal ultrasound (TVS).
To identify diagnostic parameters which are predictive of ectopic pregnancies in women with early pregnancies of unknown location.
We undertook a prospective observational study of pregnant women with suspected early pregnancy complications. Ninety-four patients were classified as having a pregnancy of unknown location (PUL) by transvaginal ultrasound; blood sample was taken on presentation to measure the serum human chorionic gonadotrophin (,-HCG) and progesterone levels. All collected data were tested by univariate analysis and then analyzed in a stepwise procedure to form a logistic model for predicting ectopic pregnancy.
A total of 2675 women were referred for suspected early pregnancy complications. In 94 (4%) patients the location of the pregnancy was unknown. Three parameters were found to be statistically significant for predicting ectopic pregnancy:progesterone level, vaginal bleeding associated with pain and the presence of free fluid in the pouch of Douglas. The overall model described by these variables offer a sensitivity of 79 %and a specificity of 59% in the prediction of ectopic pregnancy.
Logistic regression model can help in the clinical decision-making in women with pregnancy of unknown location.
妊娠部位不明（PUL）的女性可定义为经阴道超声（TVS）未发现妊娠囊但妊娠试验呈阳性的女性。
确定可预测早期妊娠部位不明女性发生异位妊娠的诊断参数。
我们对疑似早期妊娠并发症的孕妇进行了一项前瞻性观察研究。94例患者经阴道超声检查被归类为妊娠部位不明（PUL）；就诊时采集血样以测定血清人绒毛膜促性腺激素（β-HCG）和孕酮水平。所有收集的数据先进行单因素分析，然后采用逐步法进行分析，以建立预测异位妊娠的逻辑模型。
共有2675名女性因疑似早期妊娠并发症前来就诊。其中94例（4%）患者妊娠部位不明。发现有三个参数对预测异位妊娠具有统计学意义：孕酮水平、伴有疼痛的阴道出血以及Douglas腔有无游离液。这些变量所描述的总体模型在预测异位妊娠时的敏感度为79%，特异度为59%。
逻辑回归模型有助于妊娠部位不明女性的临床决策。
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