[Value of sonography in extrauterine pregnancy]

Out of 106 treated cases of ectopic pregnancy (e.p.) at the woman's university hospital Würzburg from 1980 to 5/1984 ectopic gestation was strongly presumed in 40 patients (38%) after physical examination. Out of 71 patients additionally undergoing sonography with a clinical diagnosis of suspected e.p. in 25%, a solid-cystic tumor was described in 22 cases and an extrauterine gestational sac in four cases, thus providing a sonographic suspicion of e.p. in 37%. Totally the part of cases with presumed e.p. before operation was doubled to 51% (36 patients) by the combined use of physical and sonographic examinations. Generally interpretation of the sonographic image is only possible in relation to the clinical findings because the ultrasound appearance of e.p. is mostly non-specific and visualization of the extrauterine gestational sac with a pulsating fetal heart that solely produces evidence, is very rare. Equally the reliable exclusion of e.p. by ultrasound remains problematic. In 13 cases (18%) of the scanned group rupture of tubal pregnancy could not be avoided.