Diagnostic Value of Transvaginal Ultrasonography in the Evaluation of Ectopic Pregnancy with β-hCG Levels Lower than 1000 mIU/ml

Considering the importance of early diagnosis of ectopic pregnancy to prevent its complications and mortality, the present study was conducted with aim to determine the diagnostic value of transvaginal ultrasonography in the evaluation of ectopic pregnancy with β-hCG levels lower than 1000 mIU/ml.

This prospective study was conducted in 2020-2021 to determine the diagnostic value of transvaginal sonography in the evaluation of ectopic pregnancy in women referred to the clinic or department of gynecology in Afzalipour Hospital, Kerman. The inclusion criteria were the presence of one or more of the triad symptoms of ectopic pregnancy, i.e. abdominal or pelvic pain, amenorrhea and unusual vaginal bleeding, and serum β-hCG level less than 1000 mIU/mL. If no intrauterine gestational sac was seen and a mass indicative of ectopic pregnancy was found, or if no intrauterine gestational sac was seen without other findings outside the uterus, patients were followed up by measuring serum β-hCG levels every 48 hours until a definitive diagnosis was made. Data analysis was done using SPSS statistical software (version 22). P<0.05 was considered significant.

The mean gestational age in individuals with a correct diagnosis of ectopic pregnancy was 5.91±1.48 weeks. The sensitivity and specificity of transvaginal ultrasound were 50% and 66%, respectively. Positive and negative predictive values were measured as 78.26% and 35.71%, respectively.

In the present study, the sensitivity and specificity of transvaginal ultrasound in diagnosing ectopic pregnancy at β-hCG levels less than 1000 mIU/ml were reported as 50% and 66%, respectively. As a result, efforts to find a more accurate diagnostic method for early diagnosis of ectopic pregnancy are still needed.