Transvaginal ultrasonography for the diagnosis of ectopic pregnancy.

The transvaginal (TVU) and transabdominal (TAU) ultrasound approaches were compared in their ability to identify by direct visualization the adnexal mass of ectopic pregnancy. There were 22 patients who had a surgically proven ectopic pregnancy. The TAU approach identified the adnexal mass in 50% and the TVU approach in 91% of the patients (P less than 0.01). Below both previously reported threshold titers for the expected TAU intrauterine sac visualization, at 6500 mIU and 3600 mIU, respectively, the TVU approach allowed the identification of significantly more ectopic adnexal masses than the TAU approach. The results of the present study demonstrate the increased efficacy of TVU over TAU in the direct identification of the adnexal mass associated with ectopic gestation.