Background: Ectopic pregnancy is a major cause of first-trimester maternal morbidity and mortality. Early and accurate diagnosis is essential to prevent complications such as tubal rupture and to enable fertility-preserving management. Imaging, particularly transvaginal ultrasound, plays a central role in diagnosis, localisation, risk stratification, and guidance of management strategies in suspected ectopic pregnancy. Aim of the study was to evaluate the role of imaging in the diagnosis and management of ectopic pregnancy, to assess the correlation between ultrasound findings and clinical or surgical outcomes, and to determine the diagnostic accuracy of ultrasound in ectopic pregnancy.
Materials and Methods: This prospective observational study included 75 women with suspected ectopic pregnancy evaluated jointly by the Departments of Radiology and Obstetrics & Gynaecology at a tertiary care hospital. All patients underwent transabdominal and transvaginal ultrasonography with colour Doppler evaluation when indicated. Imaging findings were correlated with clinical features, serum ?-hCG levels, surgical findings, and follow-up outcomes.
Results: The mean age of patients was 28.6±4.9 years, with tubal ectopic pregnancy being the most common location. An adnexal mass was identified in 92% of cases, and free fluid was present in 70.7%, with echogenic haemoperitoneum significantly associated with surgical management (p<0.05). Ultrasound diagnosis correlated with surgical or clinical outcomes in the majority of cases. The sensitivity and specificity of ultrasound for diagnosing ectopic pregnancy were 92.0% and 88.2%, respectively, with an overall diagnostic accuracy of 90.7%. ROC analysis demonstrated an area under the curve of 0.91, indicating excellent diagnostic performance.
Conclusion: Transvaginal ultrasound is a highly accurate and reliable imaging modality for the diagnosis and management of ectopic pregnancy. Imaging findings strongly correlate with clinical and surgical outcomes and play a decisive role in guiding appropriate management. Standardised imaging protocols and structured follow-up can further improve outcomes in suspected ectopic pregnancy.
International Journal of Clinical Obstetrics and Gynaecology
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Research Journals