Can Ectopic Pregnancy Be Seen On Ultrasound?

An undetected ectopic pregnancy (or tubal pregnancy) is a condition that can be dangerous for pregnant women. In severe cases, the patient may develop a ruptured fallopian tube. Early diagnosis of ectopic pregnancy with ultrasound is very important and can be treated accordingly.

As a pregnant woman, you may have heard from your friends about the condition and worry about if it also poses a risk to your unborn baby.

ectopic pregnancy ultrasound images

In most cases, women with tubal pregnancy visit a doctor in the early stages of pregnancy when they have cramping or bleeding. Although these issues may seem to be a part of normal pregnancy, sometimes your doctor may diagnose signs of ectopic pregnancy or miscarriage.

The condition can especially become obvious when the doctor finds out an abnormal lump in the tubal area or if the patient suffers from a severe tenderness or abdominal pain.

Signs of a ruptured tubal pregnancy can be diagnosed in a combination with early ultrasound and hCG levels.

How Early Can Ectopic Pregnancy Be Detected By Ultrasound?

An ectopic pregnancy can be diagnosed at 5-6 weeks of pregnancy by transvaginal ultrasound examination. At this stage, the hCG level is around >1500 IU/l.

Symptoms And Signs

When Do Ectopic Pregnancy Symptoms Start?

Women can start feeling the symptoms at the 6th week of gestation. In some cases, the signs of ectopic pregnancy can also be seen around 4-10 weeks.

Changes in HCG Levels in Ectopic Pregnancy

Compared to regular pregnancy, hCG levels in an ectopic pregnancy often rise slower. Although this alone isn’t enough to confirm tubal pregnancy, your doctor may see it as a sign as well.

Slow rising hCG can also signify a viable pregnancy. In addition, since around 20 percent of ectopic pregnancies have normal rising HCG levels, your doctor will ask you to go through an ultrasound checkup.

Ectopic Pregnancy Treatment

Depending on the patient’s individual situation one of the following 3 options of treatment may apply:

  1. When it comes to the treatment of ectopic pregnancy, your doctor may simply recommend you to monitor hCG levels if he thinks that pregnancy will end naturally.
  2. In cases that there is no sign of rupture, an ectopic pregnancy is generally treated with methotrexate.
  3. On the other hand, a surgical operation might be the last option if there is a risk that ectopic pregnancy may lead to the rupture of the tube.

Laparoscopy For Ectopic Pregnancy 

In ectopic pregnancies, two types of laparoscopic surgeries are carried out: salpingectomy and salpingostomy. During the operation, the surgeon makes a small incision in the abdomen, near the navel. Next, the doctor views the tubal area by using a camera that is attached to a thin tube.

Ruptured Ectopic Pregnancy Ultrasound

Ectopic pregnancy may be diagnosed with an early ultrasound and regularly monitored HCG levels. However, in cases of ruptured tubal pregnancy, pregnant women have to be immediately taken to surgery.

Ovarian Ectopic Pregnancy Ultrasound

As opposed to certain types of ectopic pregnancy, ovarian ectopic pregnancies are rarely seen. The signs of ovarian ectopic pregnancy are often associated with abdominopelvic pain during the first trimester.

The treatment of the condition is generally carried out by surgical resection of the involved organ.

Interstitial (Or Cornual) Ectopic Pregnancy Ultrasound

As opposed to the conditions mentioned above, interstitial (or cornual) pregnancy carries a higher risk of rupture as well as hemorrhage. 3D ultrasound analysis of cornual ectopic pregnancy may be helpful for delineating a gestational sac’s location since it shows an intrauterine gestational sac or decidual reaction located high in the fundus.

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