[Improved diagnosis of extrauterine pregnancy by endosonography]

Between July 1987 and January 1988, 44 patients with a tentative diagnosis of ectopic pregnancy underwent sonographic examination by means of vaginal probe at the Department of Gynecology and Obstetrics of the RWTH Aachen. The sonographic findings, all of which were confirmed by subsequent clinical and or surgical clarification, were as follows: an ectopic pregnancy was diganosed in 16 cases, an early intrauterine pregnancy in seven, an intrauterine abortion in seven, and in one case a uterine malformation-a dermoid cyst and a functional cyst. In 11 cases sonographic examination showed the interior genital region to be normal, with no sign of pregnancy. In the 16 ectopic pregnancies diagnosed, it was possible in 13 cases to visualize the pregnancy directly by sonography, including the amniotic sac, and to make measurements. In one case a normally developed ectopic pregnancy with living embryo was seen at the end of the seventh week of gestation post menstruationem. In the remaining three cases the diagnosis was established on the basis of an empty cavum uteri associated with a slightly enlarged uterus and demonstration of fluid in the pouch of Douglas. In two cases the ectopic pregnancy was correctly localized by "feeling" with the intravaginal probe to establish the cause of circumscribed pain. In three case the tentative diagnosis of an ectopic pregnancy made on the basis of sonographic findings was not confirmed by subsequent clarification procedures. The results described show that in most cases ectopic pregnancies can be demonstrated directly by sonography using an intravaginal probe.(ABSTRACT TRUNCATED AT 250 WORDS)