title: 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.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Fifty patients with ampullary pregnancy.
  
  
  METHODS
  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.
  
  
  METHODS
  Association between ultrasound images and serum concentrations of VEGF.
  
  
  RESULTS
  An association was found between ultrasonographic images and VEGF serum concentrations. Ectopic embryos with cardiac activity were associated with higher levels of serum VEGF.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Obstetrics and Gynecology, University of São Paulo, São Paulo, Brazil. Electronic address: fabiocabar@uol.com.br.
authors.forename: Fábio Roberto
authors.initials: FR
authors.lastname: Cabar
authors.affiliation: Department of Obstetrics and Gynecology, University of São Paulo, São Paulo, Brazil.
authors.forename: Pedro Paulo
authors.initials: PP
authors.lastname: Pereira
authors.affiliation: Department of Pathology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
authors.forename: Regina
authors.initials: R
authors.lastname: Schultz
authors.affiliation: Department of Obstetrics and Gynecology, University of São Paulo, São Paulo, Brazil.
authors.forename: Rossana Pulcinelli
authors.initials: RP
authors.lastname: Francisco
authors.affiliation: Department of Obstetrics and Gynecology, University of São Paulo, São Paulo, Brazil.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Zugaib
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D010298:Parity; D011247:Pregnancy; D011274:Pregnancy, Tubal / Q000097:blood* / Q000000981:diagnostic imaging*; D011374:Progesterone / Q000097:blood; D011446:Prospective Studies; D016216:Ultrasonography, Prenatal; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*; D055815:Young Adult
chemical_list: C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D011374:Progesterone
keywords: Transvaginal sonography; VEGF; ampullary pregnancy; ectopic pregnancy; first trimester hemorrhage