Ozel Sule, Alkan Mihriban, Tokmak Aytekin, Oksuzoglu Aysegul, Kaya Melike, Aktulay Ayla, Engin-Ustun Yaprak
Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
Department of Radiology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
J Reprod Infertil. 2021 Jan-Mar;22(1):32-37. doi: 10.18502/jri.v22i1.4993.
The purpose of the current study was to investigate the presence of polycystic ovarian morphology (PCOM) in patients with ectopic pregnancy (EP) and to find out the value of sonographic appearance of ovaries on the earlier diagnosis of EP.
In the current case-control study, thirty five patients with EP were recruited to evaluate ovarian sonographic morphology whereas 35 gestational age-matched women with healthy intrauterine pregnancy (IUP) were the controls. After ovarian sonography, ultrasound images were analyzed offline for ovarian area, ovarian volume, follicle number per cross section, and follicle distribution pattern. A questionnaire about the presence of hirsutism and menstrual irregularity prepared as well. Student's t-test or Mann-Whitney U test were used to compare continuous variables between 2 groups and categorical data were evaluated by using Chi-square or Fisher's exact test, where appropriate. Multiple logistic regression was used to find out the risk factors for EP.
Mean gravidity and parity were significantly higher in the EP group compared to IUP group (p<0.05). PCOM was found to be significantly higher in the study group (51.4% . 20%, p=0.006). Logistic regression analysis showed that multiparity (OR=8.635; 95% CI, 1.653-45.104) and PCOM image on ultrasound (OR=19.081; 95% CI, 1.139-319.560) were found to be significantly associated with EP.
PCOM is more prevalent among women diagnosed with EP. This study demonstrates that PCOM assessed by transvaginal ultrasound may reflect EP in women with EP suspicion and may therefore serve as a clinical marker to assess EP.
本研究旨在调查异位妊娠（EP）患者中多囊卵巢形态（PCOM）的存在情况，并探讨卵巢超声表现对EP早期诊断的价值。
在这项病例对照研究中，招募了35例EP患者以评估卵巢超声形态，同时选取35例孕周匹配的宫内妊娠（IUP）健康女性作为对照。进行卵巢超声检查后，离线分析超声图像以测量卵巢面积、卵巢体积、每个横截面的卵泡数量以及卵泡分布模式。还准备了一份关于多毛症和月经不规律情况的问卷。采用Student's t检验或Mann-Whitney U检验比较两组间的连续变量，分类数据在适当情况下使用卡方检验或Fisher精确检验进行评估。使用多因素逻辑回归分析来确定EP的危险因素。
与IUP组相比，EP组的平均妊娠次数和产次显著更高（p<0.05）。研究组中PCOM的发生率显著更高（51.4% 对20%，p=0.006）。逻辑回归分析显示，多产（OR=8.635；95% CI，1.653 - 45.104）和超声检查显示的PCOM图像（OR=19.081；95% CI，1.139 - 319.560）与EP显著相关。
PCOM在诊断为EP的女性中更为普遍。本研究表明，经阴道超声评估的PCOM可能反映可疑EP女性的EP情况，因此可作为评估EP的临床标志物。
