Ectopic pregnancy: duplex Doppler evaluation.

Abstract

Of 398 patients in whom there was a clinical suspicion of ectopic pregnancy, 96 (24%) were found to have the condition. Of the 96, 70 underwent duplex Doppler imaging. A viable ectopic fetus was seen in 10 of 70 (14%), and an extrauterine sac without an identifiable fetus was seen in an additional 27, giving a sensitivity for imaging alone of 53%. Fetal heart activity was detected with Doppler in 13 (19%). High-velocity flow, which suggested the presence of an ectopic pregnancy, was detected in 38 of 70 (54%) patients (total preoperative sensitivity, 73%). In the 91 patients who did not have an ectopic pregnancy, duplex Doppler imaging of the intrauterine contents alone allowed an ectopic pregnancy to be excluded in 29 (32%) on the first examination and in a further 21 on the second scan (specificity, 55%). Nine vascular adnexal masses were falsely considered to be ectopic pregnancies (specificity, 90%). The positive predictive values were 47% for imaging alone and 85% for Doppler. The negative predictive values were 60% for imaging alone and 81% for Doppler.

Heterotopic Pregnancy in a Natural Conception

“…They report that identification of this type of flow pattern in an adnexal mass using transvaginal color Doppler has a sensitivity of 96% and a specificity of 93%. 9 In other cases, it may be difficult to differentiate an ectopic pregnancy from a hemorrhagic corpus luteum cyst. Presence of moderate or large amounts of intraperitoneal bleed should obviously raise suspicion of ectopic pregnancy.…”

A Case of Heterotopic Pregnancy in the Absence of Risk Factors

“…A suspicious adnexal mass can be investigated further with Doppler ultrasound in an attempt to improve sensitivity and specificity. Taylor et al [12] have described a high velocity, low resistance Doppler signal that is associated with the developing trophoblasts. They report that identification of this type of flow pattern in an adnexal mass using transabdominal ultrasound raised the sensitivity for the diagnosis of an ectopic pregnancy from 53 to 73%.…”

Endovaginal color Doppler sonographic evaluation of ectopic pregnancy in women after in vitro fertilization and embryo transfer

“…Taylor et al [13] described placental flow as a relatively high-velocity, low-impedance signal confined to the site of placentation whether localized in the uterus or in the adnexa. Taylor et al [13] also assumed that placental flow is related to invasion of the maternal tissues by trophoblastic villi.…”