ULTRASONOGRAPHIC ENDOMETRIAL 3-LAYER PATTERN - A UNIQUE FINDING IN ECTOPIC PREGNANCY

Although diagnostic ultrasonography is playing an increasing role in t he investigation of the patient with suspected ectopic pregnancy (EP), it has significant limitations in the very early stages of pregnancy. By sonographically exploring the intrauterine echoes in 45 cases of d ocumented EP, we demonstrated a unique pattern in 28 cases (62.2%). A well-defined spheric structure forming an endometrial three-layer (ETL ) pattern was seen, probably formed by a midline echo between the two adjacent edematous proliferative layers of the endometrium, the latter resembling the late proliferative endometrium. In 17 patients with a proved EP (37.8%), the ETL pattern was not demonstrated. However, the ETL was not demonstrated in all 40 cases of early intrauterine pregnan cy and all 50 cases of miscarriage. These findings suggest a 100% spec ificity and a sensitivity of 62.2% for the ETL pattern in the diagnosi s of EP. (C) 1996 John Wiley & Sons, Inc.