Ultrasound diagnosis of ectopic pregnancy

The diagnosis of tubal ectopic pregnancy should be based upon the positive visualization of an adnexal mass using transvaginal ultrasound rather than the absence of an intrauterine gestational sac. Ultrasound diagnosis earlier in the natural history of the condition has meant that more conservative treatment options can be considered and implemented in clinically stable women. Although laparoscopy traditionally is accepted as the gold standard in the diagnosis of tubal ectopic pregnancy, there is substantial evidence that transvaginal ultrasound is the diagnostic tool of choice in modern practice. In expert hands, this single noninvasive and reproducible diagnostic test correlates well with the presence of ectopic pregnancy at the time of surgery. This article discusses the use of ultrasound as a single stand-alone test in the diagnosis of tubal ectopic pregnancy.