{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T19:54:50Z","timestamp":1791316490604,"version":"4.3.1"},"reference-count":18,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T00:00:00Z","timestamp":1789862400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T00:00:00Z","timestamp":1789862400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2026,10]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objectives<\/jats:title>\n To compare clinical and sonographic characteristics of first\u2010trimester abdominal ectopic pregnancy (AEP) with those of tubal ectopic pregnancy (TEP), and to define ultrasound\u2010based diagnostic criteria for AEP.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This was a retrospective case\u2013control study comparing cases of AEP diagnosed at four centers with controls diagnosed with TEP, between May 2008 and May 2025. AEP was defined as a pregnancy implanted within the peritoneal cavity outside the uterus, ovaries and Fallopian tubes. We compared demographics, clinical and ultrasound findings and clinical outcomes between the groups. We identified the key ultrasound features of first\u2010trimester AEP and used these to develop refined diagnostic criteria.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n During the study period, 19 cases of AEP were identified and compared to 57 controls with TEP. The groups were matched for age, parity and gestational age at presentation. Compared with TEP, AEP was more likely to occur in pregnancies conceived via\n in\u2010vitro<\/jats:italic>\n fertilization (6\/19 (32%)\n vs<\/jats:italic>\n 5\/57 (9%); odds ratio (OR) 4.80 (95%\u2009CI, 1.27\u201318.21);\n P<\/jats:italic>\n \u2009=\u20090.02; adjusted OR (aOR), 5.02 (95%\u2009CI, 1.24\u201320.25);\n P<\/jats:italic>\n \u2009=\u20090.02) and patients with AEP were less likely to present with vaginal bleeding (5\/18 (28%)\n vs<\/jats:italic>\n 40\/57 (70%); OR, 0.16 (95%\u2009CI, 0.05\u20130.53);\n P<\/jats:italic>\n \u2009=\u20090.003; aOR, 0.17 (95%\u2009CI, 0.05\u20130.64);\n P<\/jats:italic>\n \u2009=\u20090.009). With respect to clinical outcomes, patients with AEP were more likely to have significant blood loss (\u2265\u2009500\u2009ml) at surgery (4\/16 (25%)\n vs<\/jats:italic>\n 1\/36 (3%); OR, 11.67 (95%\u2009CI, 1.18\u2013114.90);\n P<\/jats:italic>\n \u2009=\u20090.04) and require blood transfusion (4\/19 (21%)\n vs<\/jats:italic>\n 0\/56 (0%);\n P<\/jats:italic>\n \u2009=\u20090.003). Four diagnostic ultrasound criteria for AEP were identified: (1) the presence of a gestational sac or trophoblast separate from the uterus and ovaries; (2) the absence of a hypoechogenic tissue layer surrounding the pregnancy; (3) a negative \u2018sliding organs\u2019 sign; and (4) trophoblastic blood flow arising from the peritoneum detected on color Doppler examination.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Assisted conception is a risk factor for a pregnancy implanting into the peritoneal cavity. Early ultrasound diagnosis of AEP is important to reduce the risk of major intra\u2010abdominal bleeding, which is significantly higher in AEP compared with TEP. \u00a9 2026 The Author(s).\n Ultrasound in Obstetrics & Gynecology<\/jats:italic>\n published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/uog.70342","type":"journal-article","created":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T07:29:45Z","timestamp":1789889385000},"page":"571-579","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Imaging in gynecological disease (32): clinical and ultrasound characteristics of early abdominal ectopic pregnancy"],"prefix":"10.1002","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6617-3065","authenticated-orcid":false,"given":"L.","family":"Berg","sequence":"first","affiliation":[{"name":"EGA Institute for Women's Health, Faculty of Population Health Sciences University College London (UCL) London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2563-2605","authenticated-orcid":false,"given":"L. V.","family":"de Braud","sequence":"additional","affiliation":[{"name":"EGA Institute for Women's Health, Faculty of Population Health Sciences University College London (UCL) London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0264-2966","authenticated-orcid":false,"given":"E.","family":"Bean","sequence":"additional","affiliation":[{"name":"Barking Havering and Redbridge University Hospitals NHS Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Lomheim","sequence":"additional","affiliation":[{"name":"Mandal Spesialistsenter Mandal Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0961-7296","authenticated-orcid":false,"given":"L.","family":"Savelli","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology Unit, Morgagni\u2010Pierantoni Hospital, Forl\u00ec & University of Bologna School of Medicine Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6487-5736","authenticated-orcid":false,"given":"D.","family":"Jurkovic","sequence":"additional","affiliation":[{"name":"EGA Institute for Women's Health, Faculty of Population Health Sciences University College London (UCL) London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,20]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/hropen\/hoaa055"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d3397"},{"issue":"3","key":"e_1_2_7_4_1","first-page":"333","article-title":"Abdominal pregnancy in the United States: frequency and maternal mortality","volume":"69","author":"Atrash HK","year":"1987","journal-title":"Obstet 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