Can vaginal ultrasound detect ectopic pregnancy?

No one wants to have an ectopic pregnancy after becoming pregnant, but the clinical probability of ectopic pregnancy is still quite high. After a successful pregnancy, an important step is to rule out ectopic pregnancy. In addition to the obvious external feature of vaginal bleeding which can be used as a reference, professional examination methods are also essential. So, can vaginal ultrasound detect ectopic pregnancy? Let’s take a look below.

Vaginal ultrasound can detect ectopic pregnancy.

How is ectopic pregnancy diagnosed?

1. Pregnancy test

When the embryo is alive in the body or the trophoblast cells are active, hCG will be secreted and the pregnancy test will be positive. However, the hCG level in patients with ectopic pregnancy is lower than that in normal pregnancy. Therefore, the general hCG determination method has a low positive rate, and a more sensitive β-hCg radioimmunoassay or monoclonal antibody enzyme labeling method should be used.

2. Posterior fornix puncture

The rectouterine pouch is the place where blood is most likely to accumulate in the abdominal cavity. Even if the amount of bleeding is not large, it can be sucked out through posterior fornix puncture. During diagnosis, a long needle (No. 18) is used to pierce the rectouterine pouch from the posterior fornix of the vagina. If the blood drawn does not coagulate and is dark red, it is a positive result, indicating that there is blood accumulation in the abdominal cavity.

3. Ultrasound diagnosis

In early tubal pregnancy, B-ultrasound shows that the uterus is enlarged, but the uterine cavity is empty and there is a low-echo area beside the uterus. This image is not sonographically characteristic of tubal pregnancy, and early intrauterine pregnancy with a corpus luteum of pregnancy may need to be excluded. The use of ultrasound to detect the gestational sac and fetal heartbeat is very important in the diagnosis of ectopic pregnancy. If the pregnancy is outside the uterus, it is an ectopic pregnancy; if the gestational sac is located inside the uterus, it is basically not an ectopic pregnancy. B-ultrasound has important clinical significance for early diagnosis of interstitial pregnancy, as it can show protrusion of one uterine horn, local thickening of the muscle layer, and an obvious gestational sac inside.

4. Endometrial pathology examination

Diagnostic curettage is only suitable for patients with heavy vaginal bleeding in order to rule out intrauterine pregnancy. The uterine cavity discharge should be subjected to pathological examination. If villi are found in the section, it is an intrauterine pregnancy. If only decidua is seen without villi, although ectopic pregnancy should be considered, it cannot be used as a definite result.