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Sonographic evaluation of ectopic pregnancy.

B S Mahony, R A Filly, D A Nyberg

Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine

|May 1, 1985

Summary

Ultrasound is key for ectopic pregnancy diagnosis. Confirming an intrauterine pregnancy (IUP) with the double decidual sac sign (DDSS) helps rule out ectopic pregnancy, while adnexal findings increase suspicion.

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Area of Science:

Obstetrics and Gynecology
Diagnostic Imaging
Reproductive Medicine

Background:

Ectopic pregnancy poses significant risks to maternal health.
Accurate and timely diagnosis is crucial for effective management.
Sonography plays a vital role in evaluating suspected ectopic pregnancies.

Purpose of the Study:

To evaluate the efficacy of various sonographic findings in diagnosing ectopic pregnancy.
To determine the diagnostic value of the double decidual sac sign (DDSS) for intrauterine pregnancy (IUP).
To assess the role of adnexal findings in risk stratification for ectopic pregnancy.

Main Methods:

Prospective evaluation of women referred for sonographic assessment of ectopic pregnancy over two years.
Assessment of intrauterine and adnexal findings on ultrasound.

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Correlation of sonographic findings with pregnancy outcomes.

Main Results:

The double decidual sac sign (DDSS) accurately confirmed intrauterine pregnancy (IUP) in 42 out of 130 cases before embryo visualization.
Sonographic documentation of IUP was the only definitive evidence for the absence of ectopic gestation.
Women with suspected ectopic pregnancy and no confirmed IUP had a 43% risk of ectopic gestation.
Characterization of adnexal findings increased ectopic pregnancy risk to 70-100% in this group.
A significant 20% of surgically confirmed ectopic pregnancies had normal adnexal findings on ultrasound.

Conclusions:

The double decidual sac sign (DDSS) is a reliable early sonographic marker for intrauterine pregnancy (IUP).
Absence of sonographically confirmed IUP in at-risk patients necessitates further investigation for ectopic pregnancy.
While adnexal findings are important, normal adnexal sonograms do not exclude ectopic pregnancy.