Cytodiagnosis of uterine contents for differentiating between ectopic pregnancy and spontaneous abortion

DOI 9 References
  • KINUGASA Masato
    Department of Obstetrics and Gynecology, Amagasaki Co-op Hospital
  • TSUJIMOTO Naoki
    Department of Clinical Laboratory, Amagasaki Co-op Hospital
  • SEI Ayumi
    Department of Clinical Laboratory, Amagasaki Co-op Hospital
  • WAKUYA Jun
    Department of Diagnostic Pathology, Kobe-Kyodo Hospital

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  • 子宮内容物の細胞診による異所性妊娠と流産との鑑別診断

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Abstract

Objective : To evaluate the utility of cytodiagnosis of uterine specimens to differentiate between ectopic pregnancy and spontaneous abortion.<br>Study Design : We studied 28 women who had a pregnancy of unknown location with no possibility of normal gestation. Intrauterine specimens were prepared for cytology by direct imprinting of suctioned contents or by using endometrial cell samplers. The specimens were stained and examined on the same day. They were judged positive, suggestive of spontaneous abortion, if any syncytiotrophoblasts were detected, and judged negative otherwise.<br>Results : Ten of 13 cases of spontaneous abortion had positive cytology. In 2 cases, no chorionic villi were found histologically despite positive cytology. However, miscarriage was confirmed by a promptly declining human chorionic gonadotropin value after suction curettage. Substantial hemorrhage had already occurred before the examination in the other three cases ultimately diagnosed as complete abortion, and the cytology was negative. Fifteen cases of ectopic pregnancy were treated with surgery or methotrexate injection and 14 of them had negative cytology. The accuracy of cytodiagnosis was 86％ and the concordance rate of cytology and histology was 88％.<br>Conclusion : Cytological detection of intrauterine trophoblasts is a rapid and reliable diagnostic tool for differentiating between ectopic pregnancy and spontaneous abortion.

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