Histopathologic Evaluation of Endometrium in
Patients with Ectopic Pregnancy

Serdar DİLBAZ¹, Özlem ÖZDEĞİRMENCݹ, Berna DİLBAZ^1,

Yasemin TAŞÇI¹, Emine Seda GÜVENDAĞ GÜVEN¹, Ali HABERAL¹, Ahmet ÖZFUTTU²

Ankara-Turkey

OBJECTIVE: To evaluate the endometrial changes in patients with proven ectopic pregnancies and the value of endometrial histopathology in diagnosis of ectopic pregnancies.

STUDY DESIGN: Medical records of 71 patients with proven ectopic pregnancies and who had en­do­met­rial curettage results were reviewed. Ectopic pregnancy was confirmed either at operation or at trans­vaginal ultrasound evaluation with clearly visualized characteristic adnexal mass in the presence of an empty uterus and serum beta-subunit human chorionic gonadotropin level above the dis­cri­mi­na­tory zone. Histopathologic findings of the endometrial curettage materials were evaluated.

RESULTS: The mean age of the patients was 30±5.9 years. The mean gestational age (by date of last mens­trual period) at presentation was 36.9 days. The most common symptoms at presentation were both vaginal bleeding and missed menstruation. Review of the endometrial curettages revealed that the most common type of endometrium associated with ectopic pregnancy was secretory (52.2%) fol­lo­wed by decidual reaction (15.5%), proliferative endometrium (14.1%), Arias-Stella reaction (11.2%), and endometrial fragments (7%).

CONCLUSION: Since ectopic pregnancy is associated with various types of endometrial his­to­pat­ho­logy, it is not valuable in the diagnosis and should be performed in selected patients for differential diag­nosis when TVUS, serial serum b-HCG levels are inconclusive.

(Gynecol Obstet Reprod Med 2006; 12:000-000)

Key Words: Curettage, Ectopic Pregnancy, Endometrium, Histopathology