The Distribution of Ectopic Pregnancy in Natural Pregnancy and the Comparison of Diagnostic Efficacy between Transabdominal Ultrasound and Transvaginal Ultrasound

Abstract

Objective: The objective of this study was to analyze the advantages and disadvantages of transabdominal and transvaginal color Doppler ultrasound in the diagnosis of early ectopic pregnancy (EP) and to evaluate the value of two kinds of ultrasonography in the diagnosis of early EP. Patients and Methods: One hundred and ten EP patients who underwent preoperative transvaginal and transabdominal ultrasound examinations and were confirmed by surgical pathology were included in the study. The sonographic findings of different methods were analyzed, and the diagnostic effects of the two ultrasound methods were compared. Results: The positive rate of transvaginal ultrasound for EP masses was 100%, while the positive rate of transabdominal ultrasound was 67.27%, with a significant difference (P < 0.0001). For 53 cases of EP located in the ampulla, the diagnostic rate of transvaginal ultrasound was 100%, while transabdominal ultrasound was only 58.49%, with a significant difference (P < 0.0001). The sensitivity, specificity, positive predictive value, and negative predictive value of ultrasound in diagnosing EP rupture were 94.44%, 58.67%, 52.31%, and 58.67%, respectively. Conclusions: The diagnostic efficacy of transvaginal ultrasound for EP is significantly better than that of transabdominal ultrasound. Therefore, for patients suspected of EP and without contraindication, transvaginal ultrasound is recommended as the first choice. Both peritoneal effusion by ultrasound and intraoperative abdominal hemorrhagic effusion had low specificity in diagnosing EP rupture. The diagnosis of EP rupture requires intraoperative direct vision.