Ectopic pregnancy - the leash sign. A new sign on transvaginal Doppler ultrasound

Purpose: To evaluate the efficacy of transvaginal Doppler ultrasound in the diagnosis of ectopic pregnancy. Material and Methods: Over a period of 3 years, 100 women with signs suggestive of a possible ectopic pregnancy were evaluated with endovaginal sonography and Doppler. The fallopian tubes were examined for the presence of low-resistance arterial flow. Results: Of the 100 cases, 19 women had ectopic pregnancies. It was observed that all cases of ectopic pregnancies had a typical eccentric leash of vessels on color Doppler that showed a low resistance placental type of flow on spectral Doppler. Conclusion: We propose a new reliable sign of ectopic pregnancy called the leash sign. This sign has a sensitivity of 100% and specificity of 99%, a positive predictive value of 95% and negative predictive value of 100%, thus helping in the diagnosis of early ectopic pregnancy, and resulting in earlier treatment with reduced morbidity and mortality.