The role of Ultrasound in Early Diagnosis of Gynecological Conditions During Pregnancy

Ashraf Nadaf; Nabeela Saeed; Rajesh Kumar; Sadikun Nabi; Mishal Chaudhry; Shezal Tariq

doi:10.70749/ijbr.v3i8.2143

Authors

Ashraf Nadaf Department of Radiology, Al-Dhannah Hospital, Al Dhannah City, Abu Dhabi, UAE. https://orcid.org/0000-0003-1838-325X
Nabeela Saeed Indus Hospital Health Networks, Karachi, Pakistan.
Rajesh Kumar Dow University of Health Sciences, Ojha Campus, Karachi, Pakistan.
Sadikun Nabi Combined Military Hospital, Dhaka, Bangladesh.
Mishal Chaudhry Fatima Jinnah Medical University, Lahore, Pakistan.
Shezal Tariq Department of Diagnostic Radiology, Ghurki Trust Teaching Hospital, Lahore, Pakistan

DOI:

https://doi.org/10.70749/ijbr.v3i8.2143

Keywords:

transvaginal ultrasound; early pregnancy; ectopic pregnancy; cesarean-scar pregnancy; adnexal torsion; cervical length; O-RADS/IOTA; diagnostic accuracy

Abstract

We conducted a prospective diagnostic-accuracy study across two obstetric units evaluating first-trimester ultrasound for early detection of gynecological conditions during pregnancy. Consecutive patients ≤14 weeks’ gestation underwent protocolized transvaginal scanning (with complementary transabdominal views and targeted Doppler under ALARA), structured reporting of adnexal/cervical findings (IOTA/O-RADS descriptors, cervical-length technique), and blinded verification against a composite reference standard (surgery/pathology when available or standardized 30-day clinical follow-up). Analyses (IBM SPSS v27) included accuracy metrics, ROC curves, and inter-reader reliability. Among 320 participants (prevalence of target conditions 25%), overall performance was high: sensitivity 90.0%, specificity 92.1%, accuracy 91.6%, AUC 0.94, with strong rule-in/rule-out value (LR+ 11.4; LR− 0.11). Condition-specific results were excellent for ectopic pregnancy (sensitivity 94%, specificity 97%, AUC 0.97) and strong for adnexal torsion (86%, 95%, AUC 0.93), clinically significant adnexal masses requiring surgical referral (82%, 90%, AUC 0.90), and actionable cervical pathology (80%, 92%, AUC 0.89). Reliability was substantial-to-excellent (Cohen’s κ 0.82 for categorical calls; ICC(2,1) 0.90 for cervical length), and no scan-related adverse events were recorded. These data support a protocolized first-trimester ultrasound pathway as a front-door test that delivers accurate, reproducible triage for high-impact conditions during pregnancy and is ready for health-system scale-up with standardized training, documentation, and quality audit.

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