Suspected ectopic pregnancy: endovaginal and transvesical US

Area of Science:

• Obstetrics and Gynecology
• Diagnostic Imaging
• Reproductive Medicine

Background:

• Transvesical ultrasonography (US) was the primary method for evaluating suspected ectopic pregnancies.
• Limitations existed in the diagnostic capabilities of transvesical US for early pregnancy assessment.

Purpose of the Study:

• To assess the predictive ability of both transvesical and endovaginal US.
• To determine if endovaginal US could be utilized as a standalone diagnostic tool.
• To evaluate the impact of endovaginal US on the accuracy of ectopic pregnancy diagnosis.

Main Methods:

• Fifty-three at-risk patients with positive pregnancy tests underwent both endovaginal and transvesical US.
• Retrospective (29 patients) and prospective (24 patients) examination approaches were employed.
• Standard sonographic criteria were applied to distinguish between intrauterine and ectopic pregnancies.

Main Results:

• Endovaginal US enhanced the sensitivity for detecting live ectopic pregnancies from 6% to 17%.
• Diagnostic accuracy for ectopic pregnancy increased from 60% to 83% with endovaginal US.
• Endovaginal US provided crucial additional information, particularly in early intrauterine pregnancy diagnosis.

Conclusions:

• Endovaginal ultrasonography offers significant advantages over transvesical US in suspected ectopic pregnancy cases.
• The enhanced diagnostic accuracy supports the use of endovaginal US as a primary, standalone method.
• Early and accurate diagnosis of intrauterine pregnancy via endovaginal US is key to improving ectopic pregnancy detection.