DECIDUAL CYST - ENDOVAGINAL SONOGRAPHIC SIGN OF ECTOPIC PREGNANCY

PURPOSE: To determine the prevalence of decidual cysts in patients wit h ectopic pregnancy and assess the value of endovaginal sonographic de monstration of decidual cysts in predicting ectopic pregnancy. MATERIA LS AND METHODS: A series of 288 proved ectopic pregnancies was reviewe d, and a series of 179 patients with pregnancies of less than 8 weeks menstrual age was prospectively examined. RESULTS: Decidual cysts were identified in 30 (14.4%) of 208 ectopic pregnancies. In 12 patients a decidual cyst was the first sonographic sign of ectopic pregnancy, an d in six patients it was the only abnormal sonographic finding. Four o f five patients with decidual cysts had an ectopic pregnancy. Decidual cysts had a sensitivity of 21%, specificity of 92%, positive predicti ve value of 80%, and negative predictive value of 42% in the diagnosis of ectopic pregnancy. CONCLUSION: Patients with decidual cysts are at high risk for ectopic pregnancy and should be monitored or treated ap propriately, depending on the clinical findings.