Despite advances in diagnosis made by the sensitive β-hCG determination and ultrasound(US), ectopic pregnancies still present a major diagnostic challenge. Transvaginal US was performed to evaluate the various extrauterine findings in 37
patients
at
risk for ectopic pregnancy. Of these, 31(83.8%) patients had surgically proved ectopic pregnancy(group I) and 6(16.2%) patients had no evidence of pregnancy at initial transvaginal US but subsequent proof of an intrauterine pregnancy(group II).
Extrauterine adnexal findings were demonstrated in 30(96.7%) group I patients, including an embryo and/or yolk sac in 7 (22.6%), a gestational sac in12 (38.7%), and a complex or solid mass in 11 (35.5%) but in group II the only demonstrable
findings
were a complex or solid mass in all 6 patients. Intraperitoneal free was detected in 23 (74.2%) group I patients, showing echogenic fluid in 21 (67.7%) and anechoic fluid in 2 (6.5%) but detected anechoic fluid in 2(33.3%) group II patients.
Although
specificity and positive predictive values of complex or solid mass and anechoic peritoneal fluid were low but, in comparison., those values of extrauterine gestational sac and echogenic peritoneal fluid were very high. In conclusion, this study
suggests that transvaginal US findings, combination of an extrauterine gestational sac and echogenic peritoneal free fluid, allow diagnosis of ectopic pregnancy in women referred with clinical suspicions.
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