Complicated first-trimester pregnancies: evaluation with endovaginal US versus transabdominal technique

Area of Science:

• Obstetrics and Gynecology
• Medical Imaging

Background:

• Transabdominal sonography can be inconclusive in early pregnancy assessment.
• Distinguishing intrauterine from ectopic pregnancies is critical.

Purpose of the Study:

• To evaluate the diagnostic utility of endovaginal ultrasound (US) in early pregnancy when transabdominal scans are equivocal.
• To compare the information yielded by endovaginal US versus transabdominal US.

Main Methods:

• Endovaginal ultrasound was performed in 38 pregnant women between 5-12 menstrual weeks.
• Initial transabdominal sonograms were inconclusive or equivocal.

Main Results:

• Endovaginal US correctly diagnosed all 32 intrauterine pregnancies (living, spontaneous abortions, embryonic demises).
• It visualized intrauterine embryos, heart motion, and yolk sacs more clearly than transabdominal scans.
• Absence of an intrauterine sac confirmed ectopic pregnancy in all six cases, even when an extrauterine sac was not seen.

Conclusions:

• Endovaginal sonography is highly effective for diagnosing early pregnancy complications.
• It offers superior visualization of key structures compared to transabdominal imaging.
• Endovaginal US is recommended when transabdominal scans fail to provide a definitive early pregnancy diagnosis.