DOI: https://doi.org/10.36347/sjams.2026.v14i01.014

Pages: 87-92

Background: Ectopic pregnancy remains a significant obstetric complication with the potential for severe morbidity and mortality if not identified and managed promptly. The purpose of the study is to evaluate the diagnostic accuracy of transvaginal ultrasound in distinguishing tubal ectopic pregnancy from other adnexal masses. Methods: This cross-sectional study at the Department of Radiology and Imaging, Uttara Adhunik Medical College Hospital, Dhaka, Bangladesh (June 2024–July 2025) included 80 patients with suspected ectopic pregnancy or adnexal masses. All underwent transvaginal ultrasound (TVUS), diagnoses were confirmed by surgery, histopathology, or follow-up, and TVUS diagnostic performance was assessed using sensitivity, specificity, PPV, NPV, and overall accuracy. Results: Among 80 patients (mean age 29.8 ± 4.6 years), 62.5% had tubal ectopic pregnancy and 37.5% other adnexal masses, mainly corpus luteum (46.7%) and hemorrhagic cysts (30%). TVUS showed empty uterus (92%), adnexal mass separate from ovary (88%), tubal ring (64%), and free fluid (52%) in ectopic cases, while non-ectopic masses had cystic lesions without tubal ring (90%) and lesions inseparable from ovary (83.3%). Diagnostic performance was high (sensitivity 94%, specificity 86.7%, PPV 92.2%, NPV 89.7%, accuracy 91.3%). Conclusion: Transvaginal ultrasound is a reliable and accurate tool for differentiating tubal ectopic pregnancy from other adnexal masses, facilitating early diagnosis and appropriate management.