The Sonographic Spectrum of Ectopic Pregnancy

Ectopic pregnancy occurs when a fertilized ovum implants outside the endometrial lining of the uterine cavity. Ectopic pregnancy is most commonly found in the fallopian tube but may also occur in the cervix, cesarean scar, ovary, or abdominal cavity. Ectopic pregnancy accounts for up to 13% of pregnancy-related deaths. Given the high degree of maternal mortality, recognizing an ectopic pregnancy is crucial for patient management. Clinical signs and symptoms can be nonspecific, but history of pelvic pain, vaginal bleeding, and no visualization of an intrauterine gestational sac in a patient with positive beta-human chorionic gonadotropin should raise the suspicion of an ectopic pregnancy. The place of implantation ultimately dictates treatment. Ultrasound is the imaging modality of choice for diagnosing ectopic pregnancy. This article explores the various subtypes of ectopic pregnancy and their concomitant sonographic appearances.