DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20212517

Diagnostic accuracy of transabdominal ultrasound in respect to transvaginal ultrasound in diagnosing ectopic pregnancy in a tertiary care hospital of Kolkata taking histopathology as gold standard: a prospective study

Prasun Das, Raj Saha, Srijak Bhattacharyya, Swadha Priya Basu, Debopriya Das

Abstract


Background: Ectopic pregnancy (EP) represents an important cause of acute pelvic pain in women of reproductive age. Initial evaluation consists of appropriate history and clinical examination followed by pelvic ultrasonography (US) and hormonal assays. Objective of the study was to measure diagnostic accuracy of TAS in respect to TVS in detecting ectopic pregnancy.

Methods: This prospective cross sectional study was done for 1 year duration in Nilratan Sircar Medical College and Hospital, Kolkata. 50 patients with suspected ectopic pregnancy were transferred from Gynae emergency ward and trans-abdominal, transvaginal ultrasound were subsequently performed on each. The results were corroborated with histopathology reports..

Results: Diagnostic parameters of TAS in respect to HPE:sensitivity 75.5, specificity-80,PPV-97.1, NPV-26.6 (all in percentages). Diagnostic parameters of TVS in respect to HPE:sensitivity 86.6, specificity-80, PPV-97.5, NPV-40 (all in percentages).

Conclusions: Sonography by transvaginal route stood way ahead of trans abdominal scan in terms of all diagnostic parameters to correctly evaluate ectopic pregnancy.


Keywords


Ectopic pregnancy, Transabdominal ultrasound, Transvaginal ultrasound

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References


Practice Committee of the American Society for Reproductive Medicine. Medical treatment of ectopic pregnancy: a committee opinion. Fertil Steril. 2013;100:638-44.

Gurel S, Sarikaya B, Gurel K. Role of Sonography in the diagnosis of ectopic pregnancy. J Clin Ultrasound. 2007;35:509-17.

Marye N, Leslie S, Vickie F. Callen’s ultrasonography in obstetrics and gynecology. 6th Edition. 2017:967.

Lipscomb GH, Stovall TG, Ling FW. Nonsurgical treatment of ectopic pregnancy. N Engl J Med. 2000;343:1325-9.

Ankum WM, Veen F, Hamerlynck JV, Lammes FB. Laparoscopy: a dispensable tool in the diagnosis of ectopic pregnancy? Hum Reprod. 1993;3:1301-6.

Condous G, Okaro E, Khalid A. A prospective evaluation of a single-visit strategy to manage pregnancies of unknown location. Hum Reprod. 2005;20:1398-403.

Attar E. Endocrinology of ectopic pregnancy. Obstet Gynecol Clin North Am. 2004;31:779-94.

Saxon D, Falcone T, Mascha EJ. A study of ruptured tubal ectopic pregnancy. Obstet Gynecol. 1997;90:46-9.

Benacerraf BR. Filling of the bladder for pelvic sonograms: an ancient form of torture. J Ultrasound Med. 2003;22:239-41.

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.

Tritsch IE, Farine D, Rosen MG. A close look at early embryonic development with the high-frequency transvaginal transducer. Am J Obstet Gynecol. 1988;159(3):676-81.

Levi CS, Lyons EA. The first trimester. In: Rumack CM, Wilson SR, Charboneau JW, Levine D, eds. Diagnostic Ultrasound (4th edition). Philadelphia: Elsevier; 2011:1099-1110.

Alsuleiman SA, Grimes EM. Ectopic pregnancy: a review of 147 cases. J Reprod Med. 1982;27(2):101-6.

Akram S. A clinic-demographic study of incidence of ectopic pregnancy and its management. Int J Health Clin Res. 2020;3(9):233-8.

Kharat D, Giri PG, Fonseca M. A study of epidemiology of ectopic pregnancies in a tertiary care hospital of Mumbai, India. Int J Reprod Contracept Obstet Gynecol. 2017;6(9):3942-6.

Arup KM, Niloptal R, Kakali SK, Pradip KB. Ectopic pregnancy- an analysis of 180 cases. J Indian Med Assoc. 2007;105:308-14.

Pal A, Gupta KB, Sarin R. A study of ectopic pregnancy and high risk factors in Himachal Pradesh. J Indian Med Assoc. 1996;94(5):172-3.

Velez BM, Mendelson EB, Freimanis MG: Transvaginal sonography in evaluating ectopic pregnancy. Semin Ultrasound. 1990;11(1):44-58.

Kim DS, Chung SR, Park MI, Kim YP. Comparative review of diagnostic accuracy in tubal pregnancy: a 14-year survey of 1040 cases. Obstet Gynaecol. 1987;70(4):547-54.

Shalev E, Yarom I, Bustan M, Weiner E, Shlomo I. Transvaginal sonography as the ultimate diagnostic tool for the management of ectopic pregnancy: experience with 840 cases. Fertil Steril. 1998;69:62-5.