{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,9,25]],"date-time":"2023-09-25T06:13:19Z","timestamp":1695622399600},"reference-count":17,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2016,1,27]],"date-time":"2016-01-27T00:00:00Z","timestamp":1453852800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2016,2]]},"abstract":"Aims<\/jats:title>The primary aim was to assess whether ectopic pregnancies (EP<\/jats:styled-content>s) visualised on primary scan behave differently to EP<\/jats:styled-content>s initially characterised as pregnancies of unknown location (PUL<\/jats:styled-content>). The secondary aim was to assess whether the EP<\/jats:styled-content> group is more likely to have surgical management compared to the PUL<\/jats:styled-content> ectopic pregnancy group.<\/jats:p><\/jats:sec>Materials and Methods<\/jats:title>Prospective observational study. Consecutive first trimester women presenting from November 2006 to March 2012 underwent transvaginal ultrasound (TVS<\/jats:styled-content>). Women diagnosed with an EP<\/jats:styled-content> on TVS<\/jats:styled-content> were divided into two groups: visualised EP<\/jats:styled-content>s noted on the first TVS<\/jats:styled-content>, and PUL<\/jats:styled-content>s which subsequently developed into EP<\/jats:styled-content>s. Twenty\u2010five historical, clinical, biochemical and ultrasonographic variables were collected. Different management strategies (expectant, medical, surgical) once an EP<\/jats:styled-content> was confirmed on TVS<\/jats:styled-content> were recorded. Univariate analysis was performed to compare differences between the two groups as well as rates for the three final management strategies.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 3341 consecutive women underwent TVS<\/jats:styled-content>. On initial scan, 86.2% were classified as intrauterine pregnancy, 8.8% as PUL<\/jats:styled-content> and 5.0% as EP<\/jats:styled-content> (145 tubal\/23 nontubal EP<\/jats:styled-content>s). There were 194 tubal EP<\/jats:styled-content>s in final analysis: 49 of 194 (25.3%) initially classified as PUL<\/jats:styled-content> and 145 of 194 (74.7%) diagnosed as EP<\/jats:styled-content> at primary TVS<\/jats:styled-content>. When comparing the EP<\/jats:styled-content> to the PUL EP<\/jats:styled-content> group, the pain scores were 3.34 versus 1.91 (P<\/jats:italic>\u2010value < 0.001), the mean sac diameters were 35.2 versus 18.5 mm (P<\/jats:italic>\u2010value = 0.0327), and the volume of the EP<\/jats:styled-content> masses were 8.21E+04 versus 1.40E+04 (P<\/jats:italic>\u2010value = 0.0341). Cumulative surgical intervention rate was significantly higher in EP<\/jats:styled-content> compared to PUL EP<\/jats:styled-content> group (P<\/jats:italic>\u2010value = 0.036).<\/jats:p><\/jats:sec>Conclusions<\/jats:title>EP<\/jats:styled-content>s seen at the first ultrasound scan appear to be more symptomatic, larger in diameter and volume compared to EP<\/jats:styled-content>s which started as PUL<\/jats:styled-content>s. Cumulative surgical intervention rate was noted to be higher in this group with EP<\/jats:styled-content> seen on ultrasound at the outset.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.12434","type":"journal-article","created":{"date-parts":[[2016,1,28]],"date-time":"2016-01-28T04:11:18Z","timestamp":1453954278000},"page":"107-112","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Is there a difference in the behaviour and subsequent management of ectopic pregnancies seen at first scan compared to those ectopic pregnancies which commence as pregnancies of unknown location?"],"prefix":"10.1111","volume":"56","author":[{"given":"Ihab","family":"Lattouf","sequence":"first","affiliation":[{"name":"Early Pregnancy, Acute Gynaecology & Advanced Endosurgery Unit Sydney Medical School Nepean Nepean Hospital University of Sydney Penrith New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chuan","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Computer Science Aberystwyth University Aberystwyth UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Pixton","sequence":"additional","affiliation":[{"name":"Early Pregnancy, Acute Gynaecology & Advanced Endosurgery Unit Sydney Medical School Nepean Nepean Hospital University of Sydney Penrith New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shannon","family":"Reid","sequence":"additional","affiliation":[{"name":"Early Pregnancy, Acute Gynaecology & Advanced Endosurgery Unit Sydney Medical School Nepean Nepean Hospital University of Sydney Penrith New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Condous","sequence":"additional","affiliation":[{"name":"Early Pregnancy, Acute Gynaecology & Advanced Endosurgery Unit Sydney Medical School Nepean Nepean Hospital University of Sydney Penrith New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,1,27]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"LewisG(ed).The Confidential Enquiry into Maternal and Child health CEMACH). 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