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[Sonographic diagnosis of ectopic pregnancy: optimal strategy?]
S Doumerc1, A Nazac, H Fernandez
1Service de Gynécologie-Obstérique, Hôpital Antoine-Béclère, 157, rue de la Porte-de-Trivaux, 92140 Clamart. sdoumerc@club-internet.fr
Aim And Methods:
The diagnostic algorithms of ectopic pregnancy (EP) include sonographic procedures. Diagnostic sensitivity is low because the procedure is operator-dependent and each clinical aspect of EP is variable. We analyzed results of standardized ultrasound procedures performed within the framework of a detailed analysis of clinical findings.
Results:
The sonographic procedure must be performed within the framework of an overall analysis including laboratory results (hCG level), examination of the decidua, localization of the corpus luteum, and careful detailed examination of adnexa. Hematosalpinx is pathognomonic of EP and is observed in 80% of cases. When diagnosis is doubtful, a second ultrasound procedure should be performed 48 hours later before undertaking laparoscopic diagnosis.
Conclusion:
The diagnostic sensitivity of ultrasonography has been consistently high in published series, undoubtedly because the studies were performed in referral centers highly experienced in diagnostic ultrasound.