[Color and pulsed Doppler ultrasonography imaging of tubal ectopic pregnancy: study of 100 cases].

OBJECTIVE: To describe the color-Doppler findings and the spectral forms of pulsed Doppler in tubal ectopic pregnancies.

MATERIALS AND METHODS: A prospective study of one hundred patients with tubal ectopic pregnancies was carried out in the emergency ward by two operators from January 1993 to March 1999. Following transabdominal and/or endovaginal sonography of the pelvis, color Doppler of the adnexa and of any suspected latero-uterine abnormal vascularity were studied with pulsed Doppler. The diastolic index (D/S) was measured on 4 consecutive complexes.

RESULTS: Sixty-six peripheral hypervascularizations, 27 irregular hypervascularizations and 7 false negatives were found with color Doppler. The pulsed Doppler spectrum revealed a low-impedance flow in 47 cases (D/S index > or = 0.35) and a high-impedance flow in 46 cases (D/S index < 0.35). The latter spectrum was found in 7 cases of tubal rupture with massive hemorrhage and 39 cases of barely evolutive ectopic pregnancies.

CONCLUSION: Color Doppler facilitated the diagnosis of small ectopic pregnancies (gestational sac less than 1 cm and echogenic lesions less than 2 cm in maximum diameter). Our work with pulsed Doppler revealed the frequence of high-impedance flow which, in the absence of massive hemoperitoneum, strongly suggests a barely evolutive ectopic pregnancy.