Two subtypes of surgery-categorized upper-lateral intracavitary pregnancy identified by MRI, a retrospective study

BMC Pregnancy and Childbirth

Research

Huan Yang¹  Ning Zheng¹  Shuo Shao¹  Weili Xie² 

[1] Department of Radiology, Jining No. 1 People’s Hospital. Six Jiankang Road, 272011, Jining, Shandong, China;School of Clinical Medicine, Jining Medical University. Forty-five South Jianshe Road, 272013, Jining, Shandong, China;Department of Radiology, Jining No. 1 People’s Hospital. Six Jiankang Road, 272011, Jining, Shandong, China;

关键词: Angular pregnancy;    Pregnancy outcome;    Magnetic resonance imaging;    Ultrasonography;    Gestational sac;   

DOI  :  10.1186/s12884-022-05274-x

 received in 2022-08-17, accepted in 2022-12-01,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundThe pregnancy outcomes in women with surgery-categorized upper-lateral intracavitary pregnancy (ULIP), previously named angular pregnancy, demonstrate higher heterogeneity than in women with ultrasonography-categorized ULIP. We aimed to use preoperative MRI and correlated clinical characteristics to explore whether the surgery-categorized ULIP comprises obstetric conditions undefined by the current ultrasonography-based diagnostic criteria.MethodsThis retrospective study involved 28 women with surgically and pathologically confirmed ULIP from January 2016 to July 2022. Two board-certified radiologists, blinded to the patients’ information, independently reviewed the MRI images, and determined each MRI feature, including endometrial thickness (EMT) and peri-gestational sac (GS) endometrial interruption. Disagreements were resolved by discussion to achieve a consensus. Based on the cutoff value of EMT (11.5 mm), the patients were divided into above-cutoff EMT (n = 22) and below-cutoff EMT (n = 6) groups.ResultsTwo subtypes of surgery-categorized ULIP were identified. Type-I ULIP (n = 22; EMT ≥ 11.5 mm), when compared to the type-II ULIP (n = 6; EMT < 11.5 mm), demonstrated lower incidence of peri-GS endometrial interruption (2/22 [9.1%] vs 6/6 [100%]; P = 0.001), higher logarithmic ß-human chorionic gonadotropin (ß-hCG) concentration (4.7 ± 0.4 mIU/ml vs 4.2 ± 0.6 mIU/ml; P = 0.026), lower rate of repeated dilatation and curettage (1/22 [4.6%] vs 4/6 [66.7%]; P = 0.003), less intraoperative blood loss (10.1 ± 6.3 ml vs 28.3 ± 18.3 ml; P = 0.001), and shorter hospital stay (2.8 ± 1.7 days vs 7.5 ± 3.8 days; P = 0.001). The peri-GS endometrial interruption negatively correlated with EMT (Odds ratio [OR] = 0.55; P = 0.001) and logarithmic ß-hCG concentration (OR = 0.08; P = 0.045). The below-cutoff EMT negatively correlated with ß-hCG concentration (OR = 0.06; P = 0.021).ConclusionsSurgery-categorized ULIP comprised two obstetric conditions among which the type-II ULIP, possessing unique imaging features undocumented in the literature, requires further attention during clinical practice.

【 授权许可】

CC BY   
© The Author(s) 2022

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