Direct diagnosis of unruptured ectopic pregnancy by real-time ultrasonography.

Real-time sonography was used in a prospective study of 32 patients as the sole diagnostic parameter for ectopic pregnancy. The minimal finding for diagnosis was an identifiable gestational sac with a circular pattern of echoes. Neither the presence or absence of an intrauterine sac nor the knowledge of either a positive or negative pregnancy test was used in the diagnosis. Among the 32 study patients, the diagnosis of ectopic pregnancy was made by sonography in nine (28.4%). Follow-up surgery confirmed the diagnosis in eight (89%). Among 23 patients with negative findings on sonography, only one was found on follow-up to have an ectopic pregnancy, for a 96% diagnostic accuracy for the negative group. Thus, of 32 patients with the potential diagnosis of ectopic pregnancy, 30 (94%) were correctly diagnosed using real-time sonography alone.