Ultrasound diagnosis of ectopic pregnancy

What is it about?

According to recent Consensus in 2011,the morphological appearance of ectopic pregnancy mass on ultrasound was classified to definite and probable ectopics. Those ectopics seen as gestational sac with embryo are the definite ectopics whereas visualization of inhomogenous mass "blob sign "or a mass with hyperechogenic ring "bagel sign " are classified as probable ectopics. we conducted a study to suggest that both blob and bagel sign should be included in the calssification of definite ectopic .Our study showed both have comparable sensitivity and specificity to the gestational sac ectopics.

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Why is it important?

The modern management of ectopic pregnancy involves surgical and non surgical options .Those patient who are diagnosed with tubal ectopic pregnancy on ultrasound demonstrating fetal echoes with or without a heart beat are directly subject to surgical management, other morphological types termed probable ectopic may impose management dilemma. When termed probable the clinician will be hesitant to offer an immediate definite management. Delay in patent management may result in serious outcome namely ectopic rupture and patient collapse. Our study result suggest that ultrasound visualization of "blob" and "bagel" sign classified as probable ectopic correlates very well with presence of actual ectopic. Subsequent patient management will be according to clinician discretion and other factors such as patient hemodynamic status ,levels of her human chorionic gonadotropin hormones and patient wishes.