A COMPARATIVE STUDY BETWEEN TRANSABDOMINAL AND TRANSVAGINAL ULTRASOUND TECHNIQUES IN EARLY DETECTION OF ECTOPIC PREGNANCY

Abstract

Background:
Ectopic pregnancy is a potentially life-threatening condition that necessitates
timely and accurate diagnosis to prevent serious complications. Ultrasonography
is important in detecting this condition early. Although the transabdominal
ultrasound is non invasive and frequently used in a clinical setup, the
transvaginal ultrasound has better resolution and much of the organs within the
pelvis are well seen during examination. This research paper will seek to compare
two diagnostic tests transabdominal and transvaginal ultrasound, to detect
ectopic pregnancies at the early stages of gestation.
Objectives: This study will aim at assessing and comparing the diagnostic
effectiveness of transabdominal and transvaginal ultrasound in the early
diagnosis of ectopic pregnancy and establish which of the two modalities of
ultrasound examination is more efficient in the early diagnosis stage to provide
better clinical outcomes to women in the early gestations.
Study design: A Cross sectional study.
Place and duration of study: From 25 November 2024 to 24 May 2025
Department of Diagnostic Radiology, Bolan Medical College/Hospital, Quetta.
Methods: The present was cross-sectional study with a sample size of 82 patients
who presented with a suspected case of the ectopic pregnancy in a tertiary care
hospital. All subjects were subjected to transabdominal and transvaginal
ultrasound investigations that were conducted by senior radiologists. The final
diagnosis was done on the basis of clinical data, beta-human chorionic
gonadotropin. content in serums, and results of surgeries. Diagnostic performance
of the two imaging modalities was carried out through statistical methods by
using SPSS version 24.0 software and in particular statistical measures of
sensitivity and specificity were considered.
Results: The average age of the 82 patients was 27.8 +/- 4.6 years.
Transvaginal ultrasound made the correct diagnosis of ectopic pregnancy in 74
cases (90.2%), whereas transabdominal ultrasound diagnosed 62 cases (75.6%).
TVUS had a higher sensitivity and specificity of 92.5 and 88.0, respectively,
than TAUS, which was 78.4 and 81.0, respectively. The diagnostic accuracy difference was statistically significant (p = 0.003). TVUS also proved to have
superior visualization of adnexal masses and free pelvic fluid. These results
substantiate the use of TVUS as a better diagnostic modality in early detection of
ectopic pregnancy.
Conclusion: Transvaginal ultrasound demonstrates superior performance in the
early detection of ectopic pregnancy when compared to transabdominal
ultrasound, offering enhanced sensitivity, specificity, and diagnostic accuracy. Its
high-resolution imaging facilitates the identification of subtle adnexal
abnormalities and the presence of free pelvic fluid, making it the modality of
choice in routine clinical practice. Incorporating transvaginal ultrasound into the
diagnostic workup for suspected ectopic pregnancy can substantially improve
early diagnosis and clinical outcomes, particularly in emergency care settings.