[The value of transvaginal sonography combined with qualitative human chorionic gonadotropin determination in suspected extrauterine pregnancy].

Effectiveness of ultrasonography, especially transvaginal sonography (TVS) combined with urinary human chorionic gonadotropin was examined in the assessment of 225 patients clinically suspected of having an ectopic pregnancy. HCG test was performed when pregnancy could not be found by transabdominal scanning. In case of negative result pregnancy was ruled out, in positive case TVS was used to localise pregnancy. In 60 patients correct diagnosis could be made with classical transabdominal scanning, TVS was required in 165 cases. In 144 patients a correct diagnosis was made during the first scan; 19 patients were rescanned for the final diagnosis. Ectopic pregnancy was successfully ruled out by transvaginal scanning in 115 patients by diagnosing an intrauterine pregnancy and 41 ectopic pregnancies were found, 33 by TVS and only 8 cases by transabdominal scanning. Two false negative identification occurred. The sensitivity, the specificity, the positive and negative predictive value of diagnosing ectopic pregnancy by TVS were 94.3%, 100%, 98.3% and 100%, respectively. The number of unruptured tubal pregnancies in this series was 64.5%. These results show that transvaginal ultrasonography is a sensitive method for diagnosing or excluding ectopic pregnancy.