TRANSVAGINAL SONOGRAPHIC FINDINGS OF CHRONIC ECTOPIC PREGNANCY

Chronic ectopic pregnancy is not precisely defined in gynecologic and sonographic texts. The diagnosis of this enigmatic clinical condition is frequently not made until laparotomy. In the present retrospective study, we evaluated the transvaginal sonographic findings of cases who were diagnosed as chronic ectopic pregnancy intraoperatively and/or p ostoperatively. The incidence of chronic ectopic pregnancy was found t o be 20.3% (62/305) of all ectopic pregnancies. Of these 62 cases, 55 had transvaginal sonographic examination. On transvaginal sonographic examination, all 55 cases of chronic ectopic pregnancy had a complex a dnexal mass with an empty uterus and only 18 (32.7%) had simple fluid in the pelvis/cul-de-sac, In the majority of cases (82.7%, n = 48), th ere was a non-homogenous echo pattern within the adnexal mass. Of 55 c ases, 30 had color Doppler flow examination, of whom none had color Do ppler flow imaging on the wall of the mass or within the mass. There w as a negative quantitative beta human chorionic gonadotropin (beta-hCG ) assay (i.e. 0 mIU/ml) in only 4 cases. Based on this study, we concl uded that chronic ectopic pregnancy is not a rare clinical entity and should be considered in differential diagnosis among patients presenti ng with an adnexal mass and an overt clinical picture. Transvaginal so nography is sensitive in diagnosing chronic ectopic pregnancy, but not specific. The combined use of transvaginal ultrasonography and beta-h CG assay increases diagnostic accuracy. However, it should be kept in mind that a negative beta-hCG value does not rule out chronic ectopic pregnancy.