loading page

Protocols for prediction of ectopic pregnancy in pregnancy of unknown location:a systematic review and meta-analysis
  • +2
  • Zhuo Chen,
  • Siyu Yang,
  • Botao Sun,
  • Wenqing Yang,
  • Yu Zhang
Zhuo Chen
Xiangya Hospital Central South University
Author Profile
Siyu Yang
Xiangya Hospital Central South University
Author Profile
Botao Sun
Xiangya Hospital Central South University
Author Profile
Wenqing Yang
Xiangya Hospital Central South University
Author Profile
Yu Zhang
Xiangya Hospital Central South University
Author Profile

Abstract

Background: The ectopic pregnancy(EP) patients requires the closely monitor. However, there is no international consensus through which method to select EP patients from the pregnancy of unknown location (PUL) patients. Objective: To summarize and review the protocols of screening patients with EP when being diagnosed with PUL. Search strategy: We searched MEDLINE, web of science and Embase from inception to May 2020. All the articles were dual-reviewed based on predetermined selection criteria. Selection criteria: Studies exploring PUL outcomes can be included. Data collection and analysis: Prediction results, final diagnosis, and expense depending on patient’s visits and examination were analyzed by R. version 3.6.3 and Revman version 5.4. Results: 29 studies were included. M6 model had the areas under the curve(AUC) of 0.944, the progesterone cut-offs an AUC of 0.725, and the M4 model an AUC of 0.871 respectively. When the sum of visits and examinations of the protocols increased from 3 to 5, the rate of lost to follow-up patients increased from 11.19% to 18.63%. The average production utility of progesterone cut-offs is 0.242, the M4 is 0.174, and the M6 is 0.157. Conclusions: The M6 model had the best performance to predict EP among the PUL patients. The progesterone cut-offs is the most cost-effective method to predict the final outcome of EP. Fundings: Project supported by National Natural Science Foundation of China (82073323) and the Joint Funds of the National Natural Science Foundation of China (U20A20368). Keywords: ectopic pregnancy, pregnancy of unknown location, predictive protocol,hCG,progesterone.