Diagnostic Accuracy of Transabdominal Ultrasound in the Diagnosis of Ectopic Pregnancy Taking Transvaginal Ultrasound as the Gold Standard

Mamoona Sattar; Shandana Khan

doi:10.70749/ijbr.v2i02.395

Authors

Mamoona Sattar Northwest General Hospital, Peshawar, KP, Pakistan.
Shandana Khan Northwest General Hospital, Peshawar, KP, Pakistan.

DOI:

https://doi.org/10.70749/ijbr.v2i02.395

Keywords:

Ectopic Pregnancy, Transabdominal Ultrasound, Diagnostic Accuracy

Abstract

Background: The diagnostic accuracy of transabdominal ultrasound in the diagnosis of ectopic pregnancy has rarely been studied in our population. Hence, the study has been planned. Objective: This study aimed to determine the accuracy of transabdominal ultrasound in the diagnosis of ectopic pregnancy, transvaginal ultrasound was used as the gold standard. Materials and Methods: This cross-sectional study was carried out at the Department of Radiology, Northwest General & Research Centre, Peshawar, from 12th June 2022 until 12th December 2022. Patients aged 15--45 years presenting with signs and symptoms of ectopic pregnancy were enrolled. Transabdominal ultrasound was performed, and the diagnostic accuracy was compared with that of transvaginal ultrasound to determine the diagnostic accuracy. The data were analysed via SPSS version 25. Results: A total of 143 patients were enrolled. The mean age of the patients was 30.01±5.518 years. The majority of the patients were aged less than 30 years (n = 84, 58.7%). The sensitivity, specificity, PPV, NPV and accuracy of transabdominal ultrasound were 93.9%, 100.0%, 100.0%, 57.8% and 94.4%, respectively. Conclusion: The clinical spectrum of ectopic pregnancy is very wide. Transabdominal ultrasound is a useful noninvasive diagnostic tool for the diagnosis of ectopic pregnancy.

Downloads

Download data is not yet available.

References

Barnhart, K. T. (2009). Ectopic Pregnancy. New England Journal of Medicine, 361(4), 379–387. https://doi.org/10.1056/nejmcp0810384

Bouyer, J. (2002). Sites of ectopic pregnancy: a 10 year population-based study of 1800 cases. Human Reproduction, 17(12), 3224–3230. https://doi.org/10.1093/humrep/17.12.3224

Kirk, E., Bottomley, C., & Bourne, T. (2013). Diagnosing ectopic pregnancy and current concepts in the management of pregnancy of unknown location. Human Reproduction Update, 20(2), 250–261. https://doi.org/10.1093/humupd/dmt047

Holdsworth-Carson, S. J., Menkhorst, E., Maybin, J. A., King, A., & Girling, J. E. (2023). Cyclic processes in the uterine tubes, endometrium, myometrium, and cervix: pathways and perturbations. Molecular Human Reproduction, 29(5). https://doi.org/10.1093/molehr/gaad012

Condous, G., Okaro, E., Khalid, A., Lu, C., Van Huffel, S., Timmerman, D., & Bourne, T. (2005). The accuracy of transvaginal ultrasonography for the diagnosis of ectopic pregnancy prior to surgery. Human Reproduction, 20(5), 1404–1409. https://doi.org/10.1093/humrep/deh770

Timor-Tritsch, I., E. & Monteagudo, A. (2012). Unforeseen consequences of the widespread use of transvaginal ultrasound in ectopic pregnancy diagnosis. Ultrasound Obstet Gynecol, 40(4), 500-7.

Shalev E, Peleg D, Tsabari A, Zuckerman H. Predictive value of transabdominal sonography in ectopic pregnancy. J Clin Ultrasound. 1998;26(2):83-6.

Hendriks, E., Rosenberg, R., & Prine, L. (2020). Ectopic pregnancy: diagnosis and management. American family physician, 101(10), 599-606.

Dooley, W. M., De Braud, L., Thanatsis, N., Memtsa, M., Jauniaux, E., & Jurkovic, D. (2021). Predictive value of presence of amniotic sac without visible embryonic heartbeat in diagnosis of early embryonic demise. Ultrasound in Obstetrics & Gynecology, 57(1), 149–154. https://doi.org/10.1002/uog.23533

WHO, U. (2019). UNFPA, World Bank Group and the United Nations Population Division. Maternal mortality: Levels and trends 2000 to 2017. Geneva: 2019.

Kagawa, H., Javali, A., Khoei, H. H., Sommer, T. M., Sestini, G., Novatchkova, M., Scholte op Reimer, Y., Castel, G., Bruneau, A., Maenhoudt, N., Lammers, J., Loubersac, S., Freour, T., Vankelecom, H., David, L., & Rivron, N. (2022). Human blastoids model blastocyst development and implantation. Nature, 601(7894), 600–605. https://doi.org/10.1038/s41586-021-04267-8

Liu, J., Liang, Y., Su, Y., Lilenga, H. S., & Zhai, J. (2024). Reasons, experiences and expectations of women with delayed medical care for ectopic pregnancies in Chinese urban edges: a qualitative study. BMJ Open, 14(3), e076035–e076035. https://doi.org/10.1136/bmjopen-2023-076035

Madhuri, C. H., Chandraprabha, N., Kiran, L., Sujatha, R., & Kumari, S. (2023). ANALYTIC STUDY OF AETIOLOGY, RISK FACTORS, CLINICAL FEATURES, DIAGNOSIS AND MANAGEMENT OF ECTOPIC PREGNANCY IN A TERTIARY CARE HOSPITAL. Int J Acad Med Pharm, 5(4), 1698-1704. https://doi.org/10.47009/jamp.2023.5.4.338

Olaleye, A. O., Babah, O. A., Osuagwu, C. S., Ogunsola, F. T., & Afolabi, B. B. (2020). Sexually transmitted infections in pregnancy – An update on Chlamydia trachomatis and Neisseria gonorrhoeae. European Journal of Obstetrics & Gynecology and Reproductive Biology, 255, 1–12. https://doi.org/10.1016/j.ejogrb.2020.10.002

Ren, F., Liu, G., Wang, T., Li, M., & Guo, Z. (2022). Unruptured ovarian ectopic pregnancy: Two case reports and literature review. Frontiers in Physiology, 13. https://doi.org/10.3389/fphys.2022.1036365

Fan, Y. Y., Liu, Y. N., Mao, X. T., & Fu, Y. (2021). The Prevalence of Ectopic Gestation: A Five-Year Study of 1273 Cases. International Journal of General Medicine, 14, 9657–9661. https://doi.org/10.2147/IJGM.S344648

Grigovich, M., Kacharia, V. S., Bharwani, N., Hemingway, A., Mijatovic, V., & Rodgers, S. K. (2021). Evaluating Fallopian Tube Patency: What the Radiologist Needs to Know. RadioGraphics, 41(6), 1876–18961. https://doi.org/10.1148/rg.2021210033

de Souza, G., Silva, R. J., Milián, I. C. B., Rosini, A. M., de Araújo, T. E., Teixeira, S. C., Oliveira, M. C., Franco, P. S., da Silva, C. V., Mineo, J. R., Silva, N. M., Ferro, E. A. V., & Barbosa, B. F. (2021). Cyclooxygenase (COX)-2 modulates Toxoplasma gondii infection, immune response and lipid droplets formation in human trophoblast cells and villous explants. Scientific Reports, 11(1). https://doi.org/10.1038/s41598-021-92120-3

Slaoui, A., Slaoui, A., Zeraidi, N., Lakhdar, A., Kharbach, A., & Baydada, A. (2022). Interstitial pregnancy is one of the most serious and uncommon ectopic pregnancies: Case report. 95, 107195–107195. https://doi.org/10.1016/j.ijscr.2022.107195

Wang, L.-T., Wang, C.-X., Sun, H.-L., Wang, X., Li, X.-F., Wang, Y.-L., & Li, Q.-C. (2020). Effect of BMI on blood value of patients on HCG day with IUI treatment. BMC Women’s Health, 20(1). https://doi.org/10.1186/s12905-020-00963-1

Aikawa, S., Matsuo, M., Akaeda, S., Sugimoto, Y., Arita, M., Isobe, Y., Sugiura, Y., Taira, S., Maeda, R., Shimizu-Hirota, R., Takeda, N., Hiratsuka, D., He, X., Ishizawa, C., Iida, R., Fukui, Y., Hiraoka, T., Harada, M., Wada-Hiraike, O., & Osuga, Y. (2024). Spatiotemporally distinct roles of cyclooxygenase-1 and cyclooxygenase-2 at fetomaternal interface in mice. JCI Insight, 9(19). https://doi.org/10.1172/jci.insight.181865

Seraj, H., Nazari, M. A., Atai, A. A., Amanpour, S., & Azadi, M. (2024). A Review: Biomechanical Aspects of the Fallopian Tube Relevant to its Function in Fertility. Reproductive Sciences, 31(6). https://doi.org/10.1007/s43032-024-01479-x

Xia, Q., Wang, T., Xian, J., Song, J., Qiao, Y., Mu, Z., Liu, H., & Sun, Z. (2020). Relation of Chlamydia trachomatis infections to ectopic pregnancy. Medicine, 99(1), e18489. https://doi.org/10.1097/md.0000000000018489

Kopelman, Z. A., Keyser, E. A., & Morales, K. J. (2021). Ectopic pregnancy until proven otherwise … even with a negative serum hCG test: A case report. Case Reports in Women’s Health, 30, e00288. https://doi.org/10.1016/j.crwh.2021.e00288