Accuracy of first-trimester ultrasound in diagnosis of tubal ectopic pregnancy in the absence of an obvious extrauterine embryo: systematic review and meta-analysis

Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology
A RichardsonN Raine-Fenning

Abstract

To determine the accuracy of ultrasound in the diagnosis of a tubal ectopic pregnancy in the absence of an obvious extrauterine embryo. This was a systematic review conducted in accordance with the PRISMA statement and registered with PROSPERO. We searched MEDLINE, EMBASE and The Cochrane Library for relevant citations from database inception to July 2014. Studies were selected in a two-stage process and their data extracted by two reviewers. Accuracy measures were calculated for each ultrasound sign, i.e. empty uterus, pseudosac, adnexal mass and free fluid in the pouch of Douglas, alone and in various combinations. Individual study estimates were plotted in summary receiver-operating characteristics curves and forest plots for examination of heterogeneity. The quality of included studies was assessed. Thirty-one studies including 5858 women were selected from 19,959 citations. Following meta-analysis, an empty uterus on ultrasound was found to predict an ectopic pregnancy with a sensitivity of 81.1% (95% CI, 42.1-96.2%) and specificity of 79.5% (95% CI, 68.9-87.1%). The corresponding performance of the pseudosac, adnexal mass and free fluid were: 5.5% (95% CI, 3.3-9.0%) and 94.2% (95% CI, 75.9-98.8%); 63.5% (95% CI, 48.5-76.3...Continue Reading

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Citations

Jul 6, 2016·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·D Levine, M McInnes
Oct 11, 2016·Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'obstétrique Et Gynécologie Du Canada : JOGC·Lucie MorinPhyllis Glanc
Oct 11, 2016·Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'obstétrique Et Gynécologie Du Canada : JOGC·Lucie MorinPhyllis Glanc
Feb 1, 2017·Journal of Biomedical Semantics·Ferdinand DhombresJean-Marie Jouannic
Feb 15, 2017·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·B NadimG Condous
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Jun 11, 2020·Case Reports in Obstetrics and Gynecology·Amr ElmoheenKhalid Bashir
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May 18, 2021·Frontiers in Medicine·Ploywarong Rueangket, Kristsanamon Rittiluechai
Jun 6, 2021·Journal of Gynecology Obstetrics and Human Reproduction·Şule Yıldırım KöpükGürkan Kıran
Oct 2, 2021·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Margarita V RevzinAnne Kennedy
Nov 15, 2016·Journal of Obstetric, Gynecologic, and Neonatal Nursing : JOGNN·Nicole S Carlson
Sep 22, 2017·Journal of Gynecology Obstetrics and Human Reproduction·P MauriceJ-M Jouannic

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