FREE ECHOGENIC PELVIC FLUID - CORRELATION WITH HEMOPERITONEUM

Echogenic fluid is an important extrauterine finding of ectopic pregna ncy. The purpose of this study was to determine how accurately echogen ic fluid correlates with hemoperitoneum at surgery Transvaginal sonogr aphy was performed in 831 consecutive patients referred to rule out ec topic pregnancy over a 36 month period. Scans were retrospectively eva luated for the presence or absence and echogenicity of free pelvic flu id. Subsequently, 185 patients had a laparotomy or laparoscopy and had documentation of the presence or absence of hemoperitoneum. On transv aginal sonography 125 patients had echogenic fluid, 30 patients had an echoic fluid, and 30 patients had no fluid. Of the 125 patients with e chogenic fluid, 122 (98%) patients had hemoperitoneum; none of the pat ients with anechoic fluid or no detected fluid had hemoperitoneum (0%) . Echogenic fluid had a sensitivity of 100%, specificity of 95%, posit ive predictive value of 98%, and an accuracy of 98% for detecting hemo peritoneum. This study demonstrates that echogenic fluid detected by t ransvaginal ultrasonography accurately correlates with hemoperitoneum detected at surgery in patients with suspected ectopic pregnancy.