Transvaginal Sonography in the Diagnosis of Ectopic Pregnancy

Abstract

To assess the usefulness of transvaginal sonography in diagnosing ectopic pregnancy, the medical records and ultrasonograms of 111 patients re ferred for transvaginal sonography with a clinical diagnosis of suspected ectopic pregnancy during a one-year period were reviewed. Of these patients, ectopic pregnancy was diagnosed in 37 women (33.33%),complete abortion in 16 women (14.42%), intrauterine pregnancy in 14 women (12.62 %) and corpus luteum cyst in 11 women (9.91 %). In each case of ectopic pregnancy in this series, at least one abnormal uterine, adnexal, or peritoneal finding was detected at transvaginal sonography. An extrauterine gestational sac with living embryo, allowing a de finitive diagnosis, is seen in only 5.4 % of cases. Certain sonographic features such as an adnexal ring or nonspecific adnexal mass with intraperitoneal fluid are helpful in making the diagnosis of an ectopic pregnancy. Because of its improved resolution of uterine and adnexal structures, transvaginal sonography is recom mended as a primary imaging modality for detailed evaluation of patients with suspected ectopic pregnancy. Meticulous transvaginal sonographic technique and a high index of suspicion will facilitate the diagnosis of ectopic pregnancy in most cases. (Thai J Obstet Gynaecol 1993;4:111-118.)