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

Abstract

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