Had A Surgical Abortion And Ultrasound Before. Could Ultrasound Show Ectopic Pregnancy?

Posted on Tue, 10 Sep 2013

Question: I had a surgical abortion and I had an ultrasound before the procedure. The ultrasound confirmed that I was pregnant. If I had an ectopic pregnancy, could this have been spotted in the ultrasound?

Answered by Dr. Kulsoom Qureshi (1 hour later)

Brief Answer:
Ultrasound can diagnose it but not in 100% cases.

Detailed Answer:
Hi XXXXXXX
Thanks for consulting us.
I feel sorry for whatever you have been through.
Ectopic pregnancy is an early pregnancy complication which can be diagnosed in more than 90% of cases by doing a TRANS-VAGINAL Ultrasound & checking seum beta hCG levels. However, still the pick up rate is not 100%.
TRANS-ABDOMINAL ultrasound has a lower sensitivity in picking up ectopic pregnancy.
Sometimes, there could be two different ongoing pregnancies. One in the womb & the other ectopic. This is known as Heterotropic pregnancy.
I have mentioned two of the common reasons of missing the diagnosis of ectopic pregnancy. In addition, the operators experience, expertise available & equipment used may all have an important role in this diagnosis.
Hope I have given you the desired response. Please write back if you want to discuss this further.
Take care.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Kulsoom Qureshi (34 minutes later)

I had a surgical abortion (sorry if you do not support this choice) but it was necessary for certain reasons. You may think my question is odd, but it has been almost 4 weeks since my abortion and I had my follow up appointment last friday where they performed a urine pregnancy test that seemed to be a higher tech test. The test consisted of my urine being dropped into a disk that swirled. My results for the pregnancy were negative. However, I get worried at practically all my symptoms and I have been having pelvic area pain, especially on the right side. My fear was that I could have an ectopic pregnancy, so the abortion missed the pregnancy and that the pregnancy test was a false negative. HOWEVER, before the abortion I had an abdominal ultrasound where the pregnancy was confirmed. My question was really trying to understand if the doctors could see if the pregnancy was not located inside my uterus. Also, are you aware of the type of pregnancy test the clinic did on my follow up? Do you know if it is accurate enough? Should I be retested, or just relax?

Answered by Dr. Kulsoom Qureshi (27 minutes later)

Brief Answer:
Have a serum beta hCG & Trans-vaginal ultrasound.

Detailed Answer:
Welcome back & thanks for your response.
Having an abortion is a matter of personal choice.
I actually got a false impression from your first question, that you had a diagnosis of ectopic pregnancy after your surgical abortion. That's why I was feeling sorry. Anyway, coming to the point, Yes I am aware of the urine test you have had. It is quite sensitive but not 100%.
If you want to exclude your doubts of having an ectopic or ongoing pregnancy. The easiest & the surest test available is a blood test called ( serum beta hCG).
In addition because of your symptoms especially pain, I recommend strongly that you have a trans-vaginal ultrasound as well. If both are negative & normal then there is absolutely no chance of you being pregnant. A course of antibiotics may resolve your ongoing problems.
Hope this answers your query. Please write back if you have any question.
Best regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar