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Vaginal sonography in ectopic pregnancy. A prospective evaluation.
Author(s) -
Rempen A
Publication year - 1988
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.7863/jum.1988.7.7.381
Subject(s) - medicine , gestational sac , yolk sac , ectopic pregnancy , gestation , echogenicity , obstetrics , gynecology , adnexal mass , pregnancy , miscarriage , transvaginal sonography , vaginal bleeding , products of conception , prospective cohort study , uterine cavity , radiology , ultrasound , uterus , surgery , embryo , genetics , microbiology and biotechnology , biology
Among 404 first‐trimester pregnancies examined with vaginal sonography in a prospective study, there were 21 ectopic gestations. Considering only the initial scans, the endometrial canal showed a linear echo surrounded by an echogenic zone in 18 cases, but in three cases the uterine cavity demonstrated a small echo‐free area representing blood. Free fluid within the cul‐de‐sac was seen in 17 patients. An adnexal tumor representing the extrauterine gestation, was detected in 19 cases. Fifteen of these masses exhibited a thick‐walled ring characteristic of a gestational sac with a viable embryo in five cases and a yolk sac in one. Other cystic adnexal masses, such as corpus luteum cysts, seen in 14 of the 21 patients were not confused with the ectopic pregnancy. A correct tentative diagnosis of ectopic gestation was made in 18 patients (86%) after the initial scan and in 20 cases (95%) including four controls. There was one false‐positive suspicion of ectopic gestation in a patient who actually had a spontaneous abortion. Interpretation of the sonographic image should generally be done in correlation with laboratory and clinical data. The results of the study indicate that vaginal sonography is a valuable diagnostic procedure in the evaluation for ectopic pregnancy.