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THE ROLE OF ULTRASOUND IN THE DIAGNOSIS OF ECTOPIC PREGNANCY CONFIRMED BY HISTOPATHOLOGY.
*Walla Mohammed Abed Al-Mola(M.B.Ch.B.)
Objective: To confirm the accuracy of trans-vaginal ultrasound in the diagnosis of ectopic pregnancy compared with trans-abdominal ultrasound confirmed by histopathological study. Setting: A longitudinal prospective study was performed at A-Batool Gynecological, Obstetrical and Infertility Teaching Hospital located in Mosul, Iraq from 1st June 2009 to 1st June 2010. Subject: Four thousand two hundred patients in early pregnancy (1st trimester) were admitted to A-Batool hospital with abdominal pain and vaginal bleeding were examined by trans-abdominal ultrasound. Results: During the analysis, the incidence was (1.9%) and the peak incidence of age was (25-29) years. The peak incidence in low parity was (1-3) (44.30%). The incidence of risk factor was the ovulation induction of 20 patients (25.3%). The common clinical presentation was the abdominal pain of 75 patients (95.0%). The ultrasonic findings in trans-abdominal was 97, and in trans-vaginal 126. The operative findings were right tubal rupture (36.71%), right tubal pregnancy (27.85%) and the most frequent type the tubal (97.4%). The most familiar site was the ampullary (88.61%), and the most common side was the right side (65.83%). The Chi-square statistical test was used in this study, in trans-abdominal sonography: the sensitivity was (87.0%), specificity was (99.0%) and accuracy (99.0%), while in trans-vaginal sonography, the sensitivity was (92.0%), specificity (100.0%). and accuracy (100.0%). Conclusion: The ultrasound is the basic modality performed to assess ectopic pregnancy. Trans-abdominal sonography should be the initial technique whereas trans-vaginal is better in the resolution. The diagnosis of ectopic pregnancy can be made with trans-vaginal ultrasound alone, but trans-abdominal should always be in conjunction with trans-vaginal ultrasound.[Full Text Article]