Association between ultrasound findings and serum levels of vascular endothelial growth factor in ampullary pregnancy

Abstract

Objective: To assess the association between ultrasound images and serum concentrations of vascular endothelial growth factor (VEGF) in ampullary pregnancies.

Design: Prospective study.

Setting: University hospital.

Patient(s): Fifty patients with ampullary pregnancy.

Intervention(s): Criteria for inclusion in the study were: singleton pregnancy from spontaneous conception; diagnosis of tubal pregnancy in the ampullary region; radical surgical treatment (salpingectomy); and measurement of serum VEGF, human chorionic gonadotropin, and progesterone on the day of surgery. An additional criterion was description of an ectopic mass by transvaginal ultrasound, as follows: [1] ectopic gestational sac containing an embryo with cardiac activity; and [2] tubal ring: a paraovarian formation similar to a gestational sac, not containing a viable embryo (an anechoic structure surrounded by a peripheral hyperechogenic halo); an empty ectopic gestational sac; a sac containing an embryo without cardiac activity; or a vitelline vesicle.

Main outcome measure(s): Association between ultrasound images and serum concentrations of VEGF.

Result(s): An association was found between ultrasonographic images and VEGF serum concentrations. Ectopic embryos with cardiac activity were associated with higher levels of serum VEGF.

Conclusion(s): In ampullary pregnancy, higher serum levels of VEGF are associated with the finding of an embryo with cardiac activity on transvaginal ultrasound. Greater production of VEGF likely creates development conditions more conducive to ectopic embryos.

Keywords: Transvaginal sonography; VEGF; ampullary pregnancy; ectopic pregnancy; first trimester hemorrhage.