Title: Comparison of Transabdominal and Transvaginal Sonography in the Diagnosis of Ectopic Pregnancy- 1yr Study

Authors: Dr Shamimun Nisa, Dr Ruplesh Mahato, Dr Savitri Bhagat

 DOI: https://dx.doi.org/10.18535/jmscr/v6i12.147

Abstract

Introduction: Sonography has become an important tool in the diagnosis of suspected ectopic pregnancy1. Ultrasonography is a cheap, widely available, simple, rapid and noninvasive diagnostic modality for fast detection, presence and location of pregnancy.

Objective: To compare transabdominal and transvaginal sonography in the diagnosis of ectopic pregnancy.

Study Design: Cross-sectional analytic study.

Study Setting: The study was conducted in VIMSAR, BURLA in the Department of Radiodiagnosis.

Study Duration: Study duration was from 1st September 2017 to 31st September 2018.

Subjects and Methods: 50 patients were included in the study. All women with suspension of ectopic pregnancy were evaluated by both transabdominal and transvaginal sonography. Diagnosis made transabdominal and transvaginal sonography ultrasound was confirmed by histopathology.

Results: Ultrasonographic findings of ectopic pregnancy were seen, including presence of extra uterine gestational sac or complex mass 94 %, absence of gestational sac in uterus 86%, fluid in the pouch of douglus 66%, thick endometrial lining or pseudo gestational sac 34%, enlargement of uterus 8%. More than one finding was seen in several patients.Most common age group with pelvic masses was between 26-30 years.

Conclusion: This study shows that transvaginal ultrasonography is superior to transabdominal ultrasonography for early detection of ectopic pregnancy.

Keywords: Ectopic pregnancy, TAB (Transabdominal ultrasound), TVS (Transvaginal ultrasound)

References

  1. Goldner TE, Lawson HW, Xia Z, et al: Survillance for ectopic pregnancy United States, 1970 – 1989. MMWR CDC Surveil Summ 42:73, 1993.
  2. Weckstein LN; Current perspective on ectopic pregnancy. Obstet Gynecol Surv; 1985; 40: 259-72.
  3. Gruzinskas JG. Miscarriage, ectopic pregnancy and trophoblastic disease. In: Edmonds DK, editor. Dewhurt’s textbook of obstetrics and gynecology for postgraduate. 6th ed. London: Blackwell sci.;1999;61-75
  4. Nyberg DA, Filly RA, Duarte Filho DL, Laing FC, Mahoney BS; Abnormal pregnancy: Early diagnosis by US and serum chorionic gonadotropin levels. Radiology; 1986; 158: 393-6.
  5. Arup KM, Niloptal R, Kakali SK, Pradip KB. Ectopic pregnancy- an analysis of 180 cases. Journal of the Indian Med Assoc. 2007;105:308-14.
  6. Pal A, Gupta KB, Sarin RA. Study of ectopic and high risk factors in Himachal Pardesh. J Indian Med Assoc 1996;94:172-3.
  7. Condous G, Okaro E and Bourne T (2003) The conservative management of early pregnancy complications: a review of the literature. Ultrasound Obstet Gynecol 22,420–430.
  8. Adhikari S, Blaivas M, Lyon M. Diagnosis and management of ectopic pregnancy using bedside transvaginal ultrasonography in the ED: a 2 year experience. Am J Emerg Med. 2007;25(6):591–596. doi: 10.1016/j.ajem.2006.11.020. [PubMed] [CrossRef]
  9. Nusheen F, Iqbal J, Faruqi NJ. Transabdomianl sonography comparison with trans vaginal sonography. Annals 2004;10:444-6.
  10. Bouyer J, Coste J, Fernandez H, Pouly JL, Sipra N. Sites of ectopic pregnancy: a 10 year population-based study of 1800 cases. Hum reprod 2002;17: 3224-30.
  11. Shalev E, Yarom I, Bustan M, Weiner E, Ben-Shlomo I. Transvaginal sonography as the ultimate diagnostic tool for the management of ectopic pregnancy: experience with 840 cases. Fertil Steril. 1998;69:62–65. [PubMed]
  12. Cacciatore B, Stenman UH, Ylostalo P. Diagnosis of ectopic pregnancy by vaginal ultrasonography in combination with a discriminatory serum hCG level of 1000 IU/L. Br J Obstet Gynaecol. 1990;97:904–908. [PubMed]
  13. Dashefsky SM, Lyon EA,Levi CS et al. Suspected ectopic pregnancy: Endovaginal and transabdominal ultrasound. Radiology 1988;169:181-184.
  14. Dillon EH, Feycock AL, TaylorKJW. Pseudogestational sacs: Doppler ultrasound differentiation from normal or abnormal intrauterine pregnancies. Radiology 190:176(2):359-364
  15. Fleischer AC, Pennell RG, McKee MS et al. Ectopic pregnancy: Features at transvaginal sonography. Radiology1990;174:375-378.

Corresponding Author

Dr Ruplesh Mahato

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Phone No: 8697552630