Journal of Ultrasound in Medicine, Vol 4, Issue 5 221-228, Copyright © 1985 by American Institute of Ultrasound in Medicine
Sonographic evaluation of ectopic pregnancy
B. S. Mahony, R. A. Filly, D. A. Nyberg and P. W. Callen
To assess sonographic findings in the evaluation for ectopic pregnancy, all
women referred over a two-year period were prospectively evaluated. The
incidence of intrauterine as well as adnexal findings was assessed in an
attempt to optimize sonographic evaluation. Visualization of a double
decidual sac sign (DDSS) within the uterus provided an accurate means of
confirming an intrauterine pregnancy (IUP) prior to embryo visualization.
Forty-two of 130 women with IUP were diagnosable only by the DDSS. As a
screening test for ectopic pregnancy, sonographic documentation of an IUP
provided the only convincing evidence for the absence of an ectopic
gestation. Any woman clinically at risk for ectopic pregnancy whose
sonogram did not confirm the presence of an intrauterine pregnancy was at
relatively high risk (43 per cent) for having an ectopic gestation.
Characterization of adnexal findings increased the level of risk for
ectopic pregnancy in these women to 70-100 per cent. However, 20 per cent
of women with a surgically confirmed ectopic pregnancy had normal adnexal
findings.
