Ectopic pregnancy
Ectopic pregnancy:
A transvaginal ultrasound isthe most important diagnostic tool for an ectopic pregnancy. Adnexal complex orsimple cyst with ring of fire appearance with colour doppler is the mostspecific feature. Presence of free fluid in pouch of douglas indicates ruptureof ectopic pregnancy. Live extra uterine pregnancy with demonstrable cardiacactivity is 100% specific of ectopic pregnancy. Empty uterine cavity with thickendometriumalso corroborates with the diagnosis. Rare presence ofpseudo-gestational sac and heterotopic pregnancy will pose challenges indiagnosis of ectopic pregnancy. Expertise and caution are both required whiledoing early pregnancyscan for evaluation and diagnosis of ectopic pregnancy.
Simple ovarian cyst:
Ovarian cyst especially simple cyst are sometimesincidental findings during a routine ultrasonography. Transvaginalultrasonography is the gold standard for assessment of ovarian cysts. Round oroval cyst with smooth thin walls suggests a simple ovarian cyst. Follicularcysts, Corpus luteal cysts and theca lutein cysts are some of the simpleovarian cysts commonly noted in women of reproductive age. Follow up requiresserial transvaginal ultrasonography. Competent and diligent ultrasonography isall that is required for thorough evaluation of simple ovarian cyst.
Complex ovarian cyst:
Diagnosis of ovarian cyst is more often done byultrasound than by physical examination. Complex ovarian cyst ultrasonographyis challenging, as it is of foremost importance for the doctor to identifydifferentiating signs of benign from malignant cysts. Irregular multilocularcysts, solid cysts, cysts with papillary structures, presence of ascites andhigh blood flow on doppler examination will all point towards malignant ovariancyst. Meticulous and complete ultrasonography arouses the suspicion of amalignant cyst and further confirmative procedures can be undertaken.
