Ultrasonic diagnosis and clinical management of singleton angular pregnancy: clinical study of a case series

Abstract

Ultrasonic diagnosis and clinical management of singleton angular pregnancy: clinical study of a case series Ling Zhang1, *, Suhua Chen1, *, Wei Li1 , Rong Liu1 , Mingfu Wu1 , Shuangmei Ye1 , Shuping Ding1 , Yihong Yang1 1Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430030 Wuhan, Hubei, China *Correspondence: zhangling0709@tjh.tjmu.edu.cn (Ling Zhang);13397182271@163.com (Suhua Chen) DOI:10.31083/j.ceog4806212 This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/). Submitted: 31 March 2021 Revised: 14 May 2021 Accepted: 9 June 2021 Published: 15 December 2021 Background: To describe the fine ultrasonic diagnostic criteria and clinical management of different types of singleton angular pregnancy. Methods: Sixty cases of angular pregnancy were collected in a single Department of Obstetrics and Gynecology from January 2016 to July 2020. The general medical history, ultrasonic images, pregnancy outcomes, surgical records, clinical management, pathological examination results and postoperative ultrasound images were collected to analyze the related risk factors, clinical manifestation, fine ultrasonic diagnostic criteria, clinical management, outcomes, and complications. Results: Among the 60 cases, 46 cases (76.7%) had related risk factors and 14 (23.3%) did not. Twenty-five cases (41.6%) had clinical symptoms of vaginal bleeding with or without lower abdominal pain and 35 cases (58.4%) had no symptoms of an abnormal pregnancy. Fifty-nine cases (98.3%) were diagnosed as different types of angular pregnancy. The number of cases of type I, II and III angular pregnancy cases was 42 (71.2%), 13 (22.0%) and 4 (6.8%), according to the gold standard diagnosis of our research. Ultrasound sensitivity in the diagnosis of type I, II and III angular pregnancy in the first trimester was 83.3%, 69.2% and 50.0%. Fifty-six cases (93.3%) resulted in a favorable outcome, while 4 cases (6.7%) showed complications. Conclusions: The different types of angular pregnancy have variable pregnancy outcomes and risks requiring clinical management to be individualized. Fine ultrasonic diagnosis is both crucial and feasible. Keywords Angular pregnancy; Placental accrete; Uterine rupture; Ultrasonic diagnosis; Clinical management