Ectopic pregnancy: transvaginal sonographic findings of 152 cases

Abstract

In a retrospective study performed on 152 cases of verified ectopic pregnancy, the features at transvaginal sonography were evaluated. A total of 146 (96%) of the patients had at least one abnormal sonographic feature and pelvic/cul-de-sac fluid was the most common finding, detected in all of the 146 patients. Pelvic/cul-de-sac fluid was particulate in 103 patients and simple in 43. Pelvic/cul-de-sac fluid together with extrauterine findings were found to be present in 93.8% (137/146) of the patients, suggesting the fact that if pelvic/cul-de-sac fluid was detected, every effort should be made to image the tube. The extrauterine transvaginal sonographic features included 102 (63.0%) patients with a mass, 60 (41.1%) with a gestational sac (with or without yolk sac or embryo), and eight (5.3%) with a living embryo. Comparison of the sonographic findings according to the status of the ectopic pregnancy revealed that particulate fluid (98.9%), and an extra-uterine mass (88.2%) were the features that aided in the diagnosis of ruptured and aborted ectopic pregnancies, whereas an extrauterine gestational sac (72.9%), and a living embryo (11.9%) were associated with intact ectopic pregnancies. Our findings support the practice of using transvaginal sonography, and ss-human chorionic gonadotropin measurements in the diagnosis and prediction of the status of ectopic pregnancy.