Transvaginal sonographic features in diagnosis of ectopic pregnancy

Tongsong, Theera; Pongsatha, Saipin

doi:10.1016/0020-7292(93)90516-y

Cited by 10 publications

(22 citation statements)

References 12 publications

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“…21 Previous sonographic studies have reported echogenic or "particulate" fluid in 25 to 57% of ectopic pregnancies. 7,16,[22][23] The higher rate in this study likely reflects the selected patient population. Although not specifically studied prior to this study, echogenic fluid has correlated with hemoperitoneum.…”

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confidence: 90%

“…Free pelvic fluid has been shown to carry a risk for ectopic pregnancy, with echogenic fluid much more worrisome in patients referred with a clinical suspicion. [5][6][7][8][9][15][16][17] Accurate characterization of pelvic fluid requires adequate gain setting. Too high gain settings can create artifactual echoes in anechoic fluid, and too low settings can cause echogenic fluid to appear anechoic.…”

Section: Discussionmentioning

confidence: 99%

“…Although not specifically studied prior to this study, echogenic fluid has correlated with hemoperitoneum. 7,16 Extrauterine findings of a mass, echogenic fluid, or both a mass and echogenic fluid were identified in 166 of the 170 ectopic pregnancies in the current study (94%). The combination of a mass and echogenic fluid was the most common finding of ectopic pregnancy in this study group.…”

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confidence: 98%

“…Both an isolated adnexal mass and the combination of an adnexal mass and pelvic fluid have been shown to carry a high risk for ectopic pregnancy. 7,16,24 Tongsong and Pongsatha have shown that the combination of echogenic free fluid and an adnexal mass carries a 95% positive predictive value for ectopic pregnancy. 16 Echogenic fluid was an isolated adnexal finding in 7% of our ectopic pregnancy patients as compared with isolated echogenic fluid and isolated fluid representing blood in 15% of ectopic pregnancy patients found in previous studies.…”

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confidence: 99%

“…7,16,24 Tongsong and Pongsatha have shown that the combination of echogenic free fluid and an adnexal mass carries a 95% positive predictive value for ectopic pregnancy. 16 Echogenic fluid was an isolated adnexal finding in 7% of our ectopic pregnancy patients as compared with isolated echogenic fluid and isolated fluid representing blood in 15% of ectopic pregnancy patients found in previous studies. 2,7 Although the echogenicity of the fluid was not specifically stated in the latter study, all patients had hemoperitoneum, which emphasizes that echogenic fluid may be the only finding in ectopic pregnancy.…”

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confidence: 99%

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Free echogenic pelvic fluid: correlation with hemoperitoneum.

Sickler

Chen

Dubinsky

et al. 1998

Journal of Ultrasound in Medicine

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ransvaginal ultrasonography has proven to be a valuable modality in evaluation of women with suspected ectopic pregnancy. [1][2][3][4] Its value lies not only in the near exclusion of ectopic pregnancy by identification of an IUP but also in the diagnosis of an ectopic pregnancy by recognition of key adnexal findings. Transvaginal ultrasonography enables the detection of extrauterine living embryos, tubal rings, complex masses, and free pelvic fluid.Pelvic fluid is an important extrauterine finding in the evaluation of a possible ectopic pregnancy. The identification of moderate to large amounts of fluid has been shown to correlate with a high risk for ectopic pregnancy. 5,6 More recently, characterizing the fluid as echogenic has been proposed as a significant extrauterine risk factor for ectopic pregnancy, regardless of the amount of fluid. 7 The purpose of this study was to evaluate how echogenic fluid detected by transvaginal ultrasonography correlates with surgically proven hemoperitoneum in suspected ectopic pregnancies. Echogenic fluid is an important extrauterine finding of ectopic pregnancy. The purpose of this study was to determine how accurately echogenic fluid correlates with hemoperitoneum at surgery. Transvaginal sonography was performed in 831 consecutive patients referred to rule out ectopic pregnancy over a 36 month period. Scans were retrospectively evaluated for the presence or absence and echogenicity of free pelvic fluid. Subsequently, 185 patients had a laparotomy or laparoscopy and had documentation of the presence or absence of hemoperitoneum. On transvaginal sonography 125 patients had echogenic fluid, 30 patients had anechoic fluid, and 30 patients had no fluid. Of the 125 patients with echogenic fluid, 122 (98%) patients had hemoperitoneum; none of the patients with anechoic fluid or no detected fluid had hemoperitoneum (0%). Echogenic fluid had a sensitivity of 100%, specificity of 95%, positive predictive value of 98%, and an accuracy of 98% for detecting hemoperitoneum. This study demonstrates that echogenic fluid detected by transvaginal ultrasonography accurately correlates with hemoperitoneum detected at surgery in patients with suspected ectopic pregnancy.

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confidence: 90%