Ectopic embryo detection using real-time sonography

An analysis of the sonograms of 60 patients with a surgically confirmed diagnosis of ectopic pregnancy was performed. In 36 examinations, both real-time and static images were compared, and real-time was judged superior in 22 based on a correlation between the original report and surgical pathology. The appearance of the endometrial canal and the adnexa was characterized in a total of 65 scans. The endometrial canal appearance was variable, with the most common finding being a linear echo (39%). The adnexal changes were less diverse, with an adnexal ring suggestive of an extrauterine gestational sac identified in 60%. In 10 cases, the adnexal ring contained a distinct fetus with a measurable crown-rump length, and cardiac activity was evident in six. Our results indicate that real-time ultrasound coupled with serum beta-hCG RIA should be the procedure of choice when ectopic pregnancy is suspected.