{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T22:59:54Z","timestamp":1789340394933,"version":"build-2803163510"},"reference-count":32,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2016,11,9]],"date-time":"2016-11-09T00:00:00Z","timestamp":1478649600000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the accuracy of three\u2010dimensional (3D) transvaginal sonographic (TVS) parameters in predicting the evolution of a pregnancy of unknown location (PUL).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective observational study performed at the early pregnancy unit of a university hospital from September 2008 to June 2012. Women with a positive pregnancy test without any signs of intra\u2010 or extrauterine pregnancy at their first TVS examination were considered eligible and a 3D dataset containing the entire uterus was acquired. An experienced observer analyzed all  3D datasets for assessment of the following parameters: endometrial thickness, volume, mean gray\u2010scale index and asymmetry. Women were followed until they were classified as having: (i) non\u2010visualized pregnancy loss (NVPL); (ii) intrauterine pregnancy (IUP); or (iii)  ectopic pregnancy or persistent PUL. We compared the values of the TVS parameters across the three groups. We also assessed the area under the receiver\u2013operating characteristics curve of the 3D\u2010TVS parameters in comparison to that for serum <jats:italic>\u03b2<\/jats:italic>\u2010human chorionic gonadotropin (<jats:italic>\u03b2<\/jats:italic>\u2010hCG) ratio (48 h\/baseline) to predict PUL outcome. We then evaluated whether combining the 3D\u2010TVS parameters with serum <jats:italic>\u03b2<\/jats:italic>\u2010hCG ratio improved the predictive accuracy for PUL outcome by performing a logistic regression analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During the study period 4939 consecutive pregnant women presented at the unit for their initial TVS examination and 325 (7%) were classified as having a PUL, of whom 161 women were enrolled and had a 3D scan of the uterus. However, 19 were excluded  because of incomplete follow\u2010up. Data from 142 women with PUL were therefore included in the analysis and the outcomes of these women were: NVPL in 98 (69%), IUP in 27 (19%) and ectopic pregnancy + persistent PUL in 14 + 3 = 17 (12%). Endometrial thickness, endometrial volume and the proportion of women with asymmetric endometrial shape  differed significantly between the outcome groups. Endometrial thickness and volume could be used as reasonable predictors of both NVPL and IUP, whereas asymmetric endometrial shape  and mean gray\u2010scale index could be used as reasonable predictors of IUP only. The best single parameter to predict PUL outcomes was the <jats:italic>\u03b2<\/jats:italic>\u2010hCG ratio. Regression analysis demonstrated that endometrial volume and endometrial shape asymmetry added significantly to the <jats:italic>\u03b2<\/jats:italic>\u2010hCG ratio in predicting IUP but not NVPL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>3D\u2010TVS markers have a low diagnostic accuracy in predicting PUL outcome. The addition of endometrial volume and shape asymmetry improves the accuracy of the <jats:italic>\u03b2<\/jats:italic>\u2010hCG ratio in predicting IUP. Copyright \u00a9 2016 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.15923","type":"journal-article","created":{"date-parts":[[2016,3,22]],"date-time":"2016-03-22T13:03:37Z","timestamp":1458651817000},"page":"650-655","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Association between three\u2010dimensional transvaginal sonographic markers and outcome of  pregnancy of unknown location: a pilot study"],"prefix":"10.1002","volume":"48","author":[{"given":"S.","family":"Reid","sequence":"first","affiliation":[{"name":"Acute Gynaecology, Early Pregnancy and Advanced Endosurgery Unit, Nepean Medical School, Nepean Hospital University of Sydney  Penrith NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Nadim","sequence":"additional","affiliation":[{"name":"Acute Gynaecology, Early Pregnancy and Advanced Endosurgery Unit, Nepean Medical School, Nepean Hospital University of Sydney  Penrith NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Bignardi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology A.O. 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