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AbstractAbstract
[en] To evaluate the sonographic findings of the heterotopic pregnancy which is increasing recently. Thirty-nine cases of heterotopic pregnancy after ovulation induction and IVF-ET (In Vitro Fertilization-Embryo Transfer) during the recent 3 years were analyzed. They were diagnosed by ultrasonography and proved surgically afterwards. Sonographic findings were analyzed focusing on gestational week of intrauterine pregnancy and location of ectopic pregnancy. In particular, adnexal mass was evaluated with regard to size and the characteristic findings such as ectopic gestational sac (echogenic ring). Also, overian cyst and fluid collection in cul-de-sac space were reviewed carefully. Heterotopic pregnancy was proved surgically by salpingectomy in 33 cases and by resection of cornus in six cases. Sonographic diagnosis using transvaginal ultrasound was made from five weeks to nine weeks two days (six weeks and four days in average) from last menstral period in all 39 cases. Ectopic pregnancy was identified in ampullary part in 29 cases, in the isthmic portion of tube in four cases and in the cornus of uterus in six cases. The intrauterine pregnancy was diagnosed by identifying the intrauterine gestational saccontaining a yolk sac in seven cases and the embryo with fetal heart beat in the remaining 32 cases. Adnexal masses of heterotopic pregnancy were less than 3 cm in diameter in 2 cases (57%), 3-4 cm in 11 cases (28%) and more than 4 cm in 6 cases (15%). A characteristic finding of ectopic mass was echogenic ring which was visible in 33 (84.6%) cases by transvaginal ultrasound. Six cases had pelvic hematosalpinx and two had pelvic hematoma. Of 10 cases (26%) which were identified to have ovarian hyperstimulation syndrome, eight (21%) had large amount of fluid collection in cul-de-sac and abdomen. Ultrasonographic identification of the intrauterine pregnancy and the ectopic chorion ring is effective for the early diagnosis of the heterotopic pregnancy.
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Journal Article
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Journal of the Korean Radiological Society; ISSN 1738-2637; ; v. 18(1); p. 33-38
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