Donald School Journal of Ultrasound in Obstetrics and Gynecology

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VOLUME 1 , ISSUE 4 ( October-December, 2007 ) > List of Articles


Ectopic Pregnancy and Ultrasound: A Review

Raydeen M Busse

Keywords : Ectopic pregnancy,ultrasound,beta-hCG,Doppler

Citation Information : Busse RM. Ectopic Pregnancy and Ultrasound: A Review. Donald School J Ultrasound Obstet Gynecol 2007; 1 (4):24-28.

DOI: 10.5005/jp-journals-10009-1116

License: CC BY-NC 4.0

Published Online: 01-12-2008

Copyright Statement:  Copyright © 2007; The Author(s).


First trimester bleeding occurs in up to 30% of all diagnosed pregnancies. Important causes of first trimester bleeding include spontaneous abortion, missed or threatened abortion, ectopic pregnancy, and gestational trophoblastic disease. One of the greatest dilemmas for clinicians is to accurately diagnose the cause of pain or bleeding, and specifically to determine if an ectopic pregnancy exists due to its grave consequences. Ectopic pregnancy occurs in almost two percent of all reported pregnancies in the United States and is the leading cause of pregnancy-related death in first trimester. When an early pregnant patient is identified who has bleeding or pain, it is crucial step to determine where the pregnancy is located. Ultrasound as a first line diagnostic tool offers an excellent opportunity for pregnancy localization. The use of the beta subunit of human chorionic gonadotropin (beta-hCG) quantification is a valuable adjunct to help determine the course and possible outcome of an early pregnancy. The goal should be to preserve the health and future reproductive capabilities of our patients.

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  1. Surveillance for ectopic pregnancy—United States, 1970-1989. MMWR Morb Mortal Wkly Rep 1993;42:73-85.
  2. Current trends ectopic pregnancy—United States, 1990-92. MMWR Morb Mortal Wkly Rep 1993;44:46-8.
  3. Ectopic Pregnancy. J Midwifery Women Health 2006;51:431-9.
  4. Ectopic pregnancy. Lancet 2005;366(9485):583-91.
  5. Risk factors for ectopic pregnancy: a meta-analysis. Fertil Steril 1996;65:1093-9.
  6. Risk factors for ectopic pregnancy: a comprehensive analysis based on a large case-control, population-based study in France. Am J Epidemiol 2003;157:185-94.
  7. Risk factors for extrauterine pregnancy in women using an intrauterine device. Fertil Steril 2000;74:899-908.
  8. Contraception 1995;52:337-41.
  9. IUD use and the risk of ectopic pregnancy: a meta-analysis of case-control studies. Contraception 1995;52:23-34.
  10. Ectopic pregnancies after infertility treatment: modern diagnosis and therapeutic strategy. Hum Reprod 2004;10:503-13.
  11. Diagnosis and management of ectopic pregnancy. Am Fam Physician 2005;72:1719-20.
  12. Early pregnancy complications: endovaginal sonographic findings correlated with human chorionic gonadotropin levels. Radiology 1988;167:619-22.
  13. Very early pregnancy detection with endovaginal ultrasound. Obstet Gynecol 1988;72:200-4.
  14. The use of transvaginal ultrasound in the diagnosis of ectopic pregnancy. Am J Obstet Gynecol 1988;161:157-61.
  15. Transvaginal sonography for diagnosing ectopic pregnancy: positivity criteria and performance characteristics. J Ultrasound Med 1994;13:259-66.
  16. Ectopic pregnancy diagnosis and the pseudo-sac. Fertil Steril 2004;81:1225-8.
  17. Should an ectopic pregnancy always be diagnosed using transvaginal ultrasonography in the first trimester prior to surgery? Ultrasound Obstet Gynecol 2003;22(Suppl 1):53.
  18. Ectopic pregnancies in caesarean section scars: the 8-year experience of one medical centre. Hum Reprod 2004;19:278-84.
  19. Cesarean scar pregnancy: issues in management. Ultrasound Obstet Gynecol 2004;23:247-53.
  20. First-trimester diagnosis and management of pregnancies implanted into the lower uterine segment Cesarean section scar. Ultrasound Obstet Gynecol 2003;21:220-7.
  21. Pregnancy in a caesarean scar pregnancy. Ultrasound Obstet Gynecol 2000;16:592-3.
  22. Risk factors for ectopic pregnancy in assisted reproduction. Fertil Steril 1999;71:282-6.
  23. Heterotopic pregnancy and assisted reproduction: an update. J Assist Reprod Genet 1996;13:594-601.
  24. Heterotopic pregnancies after in vitro fertilization and embryo transfer. Am J Obstet Gynecol 1991;164:161-4.
  25. Nonsurgical diagnosis and treatment of tubal pregnancy. Fertil Steril 1990;54:537-8.
  26. Decline of serum human chorionic gonadotropin and spontaneous complete abortion: defining the normal curve. Obstet Gynecol 2004;104:975-81.
  27. Symptomatic patients with an early viable intrauterine pregnancy: hCG curves redefined. Obstet Gynecol 2004;104: 50-5.
  28. Laparos-copy: a dispensable tool in the diagnosis of ectopic pregnancy? Hum Reprod 1993;8:1301-6.
  29. Serum human chorionic gonadotropin measurement in the diagnosis of ectopic pregnancy when transvaginal sonography is inconclusive. Fertil Steril 1998;70:972-81.
  30. Diagnosis of ectopic pregnancy by vaginal ultrasonography in combination with a discriminatory serum hCG level of 1000 IU/l (IRP). Br J Obstet Gynaecol 1990;97:904-8.
  31. Presumed diagnosis of ectopic pregnancy. Obstet Gynecol 2002;100:505-10.
  32. The discriminatory human chorionic gonadotropin zone for endovaginal sonography: a prospective, randomized study. Fertil Steril 1994;61:1061-1120.
  33. Diagnosing ectopic pregnancy: decision analysis comparing six strategies. Obstet Gynecol 2001;97:464-70.
  34. Transvaginal color Doppler study of blood flow in ectopic pregnancies. Fertil Steril 1992;57:68-73.
  35. Early diagnosis of tubal pregnancy: changes in tubal blood flow evaluated by endovaginal color Doppler sonography. Obstet Gynecol 1993;82:561-5.
  36. Corpus luteum blood flow in normal and abnormal early pregnancy: valuation with transvaginal color and pulsed Doppler sonography. J Ultrasound Med 1994;13:971-5.
  37. Ectopic pregnancy versus corpus luteum cyst revisited: best Doppler predictors. J Ultrasound Med 2003;22:1181-4.
  38. Color and pulsed Doppler ultrasono-graphy imaging of tubal ectopic pregnancy: study of 100 cases. J Radiol 2003;84:1753-6.
  39. Ectopic pregnancy—the leash sign. A new sign on transvaginal Doppler ultrasound. Acta Radio 2006;47:529-35.
  40. Diagnosis of an interstitial pregnancy with 4-dimensional volume contrast imaging. Am J Obstet Gynecol 2005;193:1551-3.
  41. Three-dimensional transvaginal sonography of interstitial pregnancy. J Clin Ultrasound 2003;31:484-7.
  42. The shape of the endometrium evaluated with three-dimensional ultrasound: an additional predictor of extrauterine pregnancy. Human Reprod 1998;13:450-4.
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