Journal of Ultrasound in Medicine, Vol 17, Issue 7 431-435, Copyright © 1998 by American Institute of Ultrasound in Medicine
Free echogenic pelvic fluid: correlation with hemoperitoneum
G. K. Sickler, P. C. Chen, T. J. Dubinsky and N. Maklad
Department of Radiology, The University of Texas Health Sciences Center at Houston, 77030, USA.
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.
