[Sonographic diagnosis of extrauterine pregnancy]

Value of sonography in early diagnosis of ectopic pregnancy was investigated in a retrospective study. Frequency and value of different sonographic findings were analysed in 192 patients, who received laparotomy for ectopic pregnancy. In 171 patients (89%), the absence of an intrauterine sac in conjunction with a positive serum pregnancy test was the most reliable sign for ectopic pregnancy. A complex or cystic adnexal mass was found in 66 cases (32%). Hematocele or the presence of fluid in the cul-de-sac was observed in 61 patients (34%). Since an adnexal mass and retrouterine fluid or hematocele are rare sonographic findings in early ectopic pregnancy, the absence of an intrauterine sac in conjunction with a positive serum pregnancy test are of greatest significance. But correct diagnosis based on this sign is only possible considering the following conditions: 1. Evidence of pregnancy (beta-HCG in serum). 2. Gestational age more than 5 weeks. 3. Exclusion of intrauterine abortion .4. Consideration of differential diagnosis of pseudo-gestational sac and coexistence of an intra- and extrauterine pregnancy.