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4 - Ultrasound diagnosis of ectopic pregnancy

Published online by Cambridge University Press:  26 March 2010

Isabel Stabile
Affiliation:
Florida State University
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Summary

Introduction

The role of ultrasonography in suspected ectopic gestation is to localise the pregnancy. If intrauterine, ectopic pregnancy is excluded as the combination of intra- and extrauterine pregnancy (heterotopic pregnancy) is exceedingly rare in spontaneous conceptions; however, failed intrauterine pregnancy (missed, complete and incomplete abortion) may be indistinguishable from ectopic pregnancy. The introduction of transvaginal sonography (TVS) using high frequency transducers has proved a major advance in this area. Even with TVS, however, an ectopic embryo/fetus is seen in only 20% of cases (DeCrespigny, 1988). In the remainder there may or may not be other sonographic features which assist with the diagnosis. The predictive value of the vaginosonographic parameters of ectopic pregnancy is still uncertain; better images should not be equated with more accurate diagnosis (Bateman et al, 1990; Russell et al., 1993).

Comparison between abdominal and vaginal ultrasound

The major advantage of TVS over transabdominal sonography (TAS) is that TVS can diagnose normal and failed intrauterine pregnancy at least one week earlier. Most comparisons of TVS and TAS in women with abdominal pain have been retrospective (Lande et al., 1988), or not designed to compare the two techniques (Coleman et al., 1988; Lande et al., 1988), or failed to correlate sonographic findings with surgical outcome in the whole study group (Coleman et al., 1988; Lande et al., 1988; Liebman et al., 1988; Mendelson et al., 1988).

Type
Chapter
Information
Ectopic Pregnancy
Diagnosis and Management
, pp. 42 - 64
Publisher: Cambridge University Press
Print publication year: 1996

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