The Iranian Journal of Obstetrics, Gynecology and Infertility

The Iranian Journal of Obstetrics, Gynecology and Infertility

Diagnostic Value of Transvaginal Ultrasonography in the Evaluation of Ectopic Pregnancy with β-hCG Levels Lower than 1000 mIU/ml

Document Type : Original Article

Authors
Parastoo Shafiei 1
Samira Sohbati 2
Ghazal Mansouri 2
Neda Nikpour 2
Fatemeh Karami Robati 3
1 General Practitioner, Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran.
2 Assistant Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran.
3 M.Sc. in Medical Library and Information Sciences, Clinical Research Development Unit, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran.
10.22038/ijogi.2024.82916.6218
Abstract
Introduction: Considering the importance of early diagnosis of ectopic pregnancy to prevent its complications and mortality, the present study was conducted with aim to determine the diagnostic value of transvaginal ultrasonography in the evaluation of ectopic pregnancy with β-hCG levels lower than 1000 mIU/ml.
Methods: This prospective study was conducted in 2020-2021 to determine the diagnostic value of transvaginal sonography in the evaluation of ectopic pregnancy in women referred to the clinic or department of gynecology in Afzalipour Hospital, Kerman. The inclusion criteria were the presence of one or more of the triad symptoms of ectopic pregnancy, i.e. abdominal or pelvic pain, amenorrhea and unusual vaginal bleeding, and serum β-hCG level less than 1000 mIU/mL. If no intrauterine gestational sac was seen and a mass indicative of ectopic pregnancy was found, or if no intrauterine gestational sac was seen without other findings outside the uterus, patients were followed up by measuring serum β-hCG levels every 48 hours until a definitive diagnosis was made. Data analysis was done using SPSS statistical software (version 22). P<0.05 was considered significant.
Results: The mean gestational age in individuals with a correct diagnosis of ectopic pregnancy was 5.91±1.48 weeks. The sensitivity and specificity of transvaginal ultrasound were 50% and 66%, respectively. Positive and negative predictive values were measured as 78.26% and 35.71%, respectively.
Conclusion: In the present study, the sensitivity and specificity of transvaginal ultrasound in diagnosing ectopic pregnancy at β-hCG levels less than 1000 mIU/ml were reported as 50% and 66%, respectively. As a result, efforts to find a more accurate diagnostic method for early diagnosis of ectopic pregnancy are still needed.
Keywords
β-hCG Level
Diagnostic Value
Ectopic Pregnancy
Sensitivity
Specificity
Transvaginal Ultrasound
Subjects
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The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 27, Issue 8
October 2024
Pages 10-20