Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 6, 2023; 11(13): 2945-2955
Published online May 6, 2023. doi: 10.12998/wjcc.v11.i13.2945
Comparison of the application value of transvaginal ultrasound and transabdominal ultrasound in the diagnosis of ectopic pregnancy
Hui-Juan Hu, Juan Sun, Rui Feng, Liang Yu
Hui-Juan Hu, Department of Ultrasonic, Hangzhou Red Cross Hospital, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Juan Sun, Department of Ultrasonic, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou 310000, Zhejiang Province, China
Rui Feng, Department of Interventional Medicine, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou 310000, Zhejiang Province, China
Liang Yu, Department of Radiology, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou 310000, Zhejiang Province, China
Author contributions: Hu HJ and Yu L designed the study; Hu HJ wrote the manuscript; Hu HJ, Sun J, and Feng R collected and analyzed the data; Feng R and Yu L revised and reviewed the manuscript; and all authors have read and approved the final manuscript.
Institutional review board statement: The study was approved by Ethics Committee of Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine.
Informed consent statement: All study participants, or their family members, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Liang Yu, MM, Associate Chief Physician, Department of Radiology, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, 158 Shangtang Road, Hangzhou 310000, Zhejiang Province, China. 422086056@qq.com
Received: February 27, 2023
Peer-review started: February 27, 2023
First decision: March 10, 2023
Revised: March 19, 2023
Accepted: March 24, 2023
Article in press: March 24, 2023
Published online: May 6, 2023
Processing time: 57 Days and 1.9 Hours
Abstract
BACKGROUND

Ectopic pregnancy (EP) is one of the most common acute abdominal diseases in gynecology. Once the condition of EP is delayed, it may lead to massive hemorrhage, shock, and even death in a short time, seriously threatening the patient’s life. Early diagnosis is the key to preventing and improving the prognosis of EP. Transabdominal ultrasound (TAS) and transvaginal ultrasound (TVS) are the main diagnostic methods for abdominal diseases. The purpose of this study is to explore the application value and effect of TAS and TVS in the diagnosis of EP, hoping to provide more valuable references for the diagnosis of EP.

AIM

To explore the application value of TAS and TVS in the diagnosis of EP and to improve the level of clinical diagnosis.

METHODS

A total of 140 patients with EP admitted to our hospital from July 2018 to July 2020 were selected for this study. All patients were divided into two groups according to the examination methods. 63 patients who underwent abdominal ultrasound examination were set as the TAS group, while 77 patients who underwent TVS examination were set as the TVS group. We compared the diagnostic accuracy and misdiagnosis rates between the two types of ultrasound examinations, as well as the postoperative pathological results of the two diagnostic methods for different types of ectopic pregnancies. We also analyzed the sonograms for the presence of mixed ectopic masses, adnexal masses, ectopic gestational sacs, the presence or absence of visible embryo and fetal heart in the ectopic sac shadow, and the detection of fluid in the rectal fossa of the uterus, such as the adnexal area, yolk sac, and embryo, etc. In addition, the diagnosis time, days of gestational sac appearance, operation time, endometrial thickness, and blood flow resistance index were compared as well.

RESULTS

After performing both types of ultrasound examinations in 140 patients with EP, we found that the diagnostic accuracy of TVS was significantly higher than that of TAS, and the misdiagnosis rate was significantly lower than that of TAS. The differences were statistically significant (P < 0.05). In addition, the detection rate of TVS was better than that of TAS for the presence of mixed masses, adnexal masses, ectopic gestational sacs, the presence or absence of visible embryo and fetal heart in the shadow of the ectopic sac, and sonograms such as the adnexal area, yolk sac, and embryo, etc. The coincidence rate of its postoperative pathological examination results was significantly higher than those of TAS. The diagnosis time and the days of gestational sac appearance by TVS were significantly shorter than that by TAS, and the operation time was earlier than that by TAS. What’s more, the detection rates of the endometrial thickness £ 1.5 mm and blood flow resistance £ 0.5 were significantly higher in TVS diagnosis of EP than in TAS. All differences were statistically significant (P < 0.05).

CONCLUSION

Compared with TAS, TVS has the advantages of high detection accuracy and good sonogram performance.

Keywords: Transvaginal ultrasound; Transabdominal ultrasound; Ectopic pregnancy; Application value

Core Tip: Transabdominal ultrasound (TAS) is the primary method for early detection of ectopic pregnancy (EP). However, because of the low frequency of the TAS probe and the certain distance between it and the gestational sacs, it is susceptible to interference of the probe acquisition data by factors such as the filling bladder, abdominal fat, abdominal wall trabecular contents, and intestinal wall, which further reduces the accuracy of diagnosis. With the development of clinical diagnostic technology and the improvement of the medical level, transvaginal ultrasound (TVS) is gradually applied in the diagnosis of various clinical fields. Based on this, this study aims to compare and analyze the application value of TAS and TVS in the diagnosis of EP, hoping to provide some help for the early diagnosis and treatment of EP.