Color doppler in the diagnosis of ectopic pregnancy in the emergency department: is there anything beyond a mass and fluid?

Pregnant patients with first trimester complications are a common presentation in many Emergency Departments (EDs). The burden of disproving the existence of an ectopic pregnancy falls on the Emergency Physician (EP). This may be a difficult task depending on the availability of specialty backup and radiologic services. For more than a decade EPs have documented use of bedside ultrasonography for ruling out cases of ectopic pregnancy. Now, with the entry of newer technology into many emergency ultrasound programs, color Doppler is available to an increasing number of EPs. Color Doppler is used as an adjunct to diagnosing ectopic pregnancy by both radiology and gynecology practitioners and can at times provide critical information regarding early pregnancy. Presented are three cases of ectopic pregnancy diagnosed on the basis of abnormal color Doppler findings, and a discussion of the technique.