Role of usg in Ectopics: Recent Update

Abstract

This study is undertaken to emphasize the role of ultrasonography in the diagnosis of ectopic pregnancy and clinicalanalysis of the same in a tertiary care referral hospital.MethodologyOne hundred patients with provisional diagnosis of ectopic pregnancy were studied. Physical examination, urinepregnancy test, transabdominal scan using 5 MHz transducer or transvaginal ultrasonography of 7 MHz was done. Thediagnosis of ectopic pregnancy was confirmed by direct observation by laparotomy or laparoscopy (which was taken asgold standard).ResultsThe study showed ectopic pregnancy was most common in gravida 2 and in age group 26–30 years with most of themhaving married life <10 years. One or more risk factors were found in 66 % of cases. 54 % of cases presented with acutesymptoms, 14 % of cases in shock. Among clinical presentation pain abdomen, history of amenorrhea, bleeding pervaginum, abdominal tenderness, and cervical motion tenderness was most common. In ultrasonography, complex massin adnexa was present in 60 % of cases and hemoperitoneum in 50 %. 96 % of cases were tubal pregnancy with most ofthem tubal rupture. In 98 % of cases, radical surgery was done. Salpingectomy was the most common surgery done (90%). There was no negative laparotomy in this study. There was no maternal mortality in this series.ConclusionsIn all the 100 cases of ectopic pregnancy studied, the ultrasonography provided definitive diagnosis resulting in 100 %sensitivity and 100 % specificity, predictive value of positive test being 100 %. Ultrasonography done in earlier weeks ofgestation had sensitivity of 96 % and false negative 4 %