THE DIAGNOSTIC ACCURACY OF TRANSABDOMINAL SONOGRAPHY (TAS) IN EARLY (FIRST TRIMESTER) DETECTION OF ECTOPIC PREGNANCY USING HISTOPATHOLOGY AS GOLD STANDARD IN HIGH RISK PATIENTS

Abstract

Background: The ectopic pregnancy is the leading cause of pregnancy related death in the first trimester. Transvaginal sonography (TVS) is considered most sensitive and specific test for diagnosing ectopic pregnancy but its availability and expertise are limited. Since early diagnosis of ectopic pregnancy is essential to save the life and future fertility of mother, it is important to assess the value of transabdominal sonography (TAS) in diagnosis of ectopic pregnancy.

Objective: To determine the diagnostic accuracy of transabdominal sonography (TAS) in first trimester for detection of ectopic pregnancy using histopathology as gold standard in high risk patients.

Methods: Total 139 patients diagnosed with high risk for ectopic pregnancy were included. All patients underwent transabdominal sonography (TAS) performed by using convex probe with 3.75 MHz. Surgically evacuated specimens were sent for histopathology. The radiological findings on the TAS were compared with the surgical and pathological findings. Sensitivity, specificity, PPV, NPV, and accuracy of transabdominal sonography calculated taking histopathology as gold standard.

Results: Mean age was 29± 3.2 years. The TAS had a sensitivity of 89.6%, specificity of 64.2%, and accuracyof 87.05% for the diagnosis of ectopic pregnancy with 95.7% positive predictive value and 40.9% negative predictive values.

 Conclusion: The transabdominal sonography had a significant role in early detection of ectopic pregnancy and is good test for diagnosing ectopic pregnancy in our set-up.