Transvaginal Sonography in Women with First-Trimester Bleeding or Pain

First-trimester bleeding, pain, or both complicate as many as one quarter of pregnancies. In such cases, women with intrauterine pregnancies identified with transvaginal sonography (TVS) usually receive routine outpatient care. However, diagnostic uncertainty arises when TVS in the setting of early bleeding or pain does not identify intrauterine pregnancy. In a cohort study of women with first-trimester bleeding, pain, or both conducted at a U.S. teaching hospital, researchers assessed the diagnostic accuracy of TVS. Initial TVS diagnoses among women who presented to the emergency department with first-trimester pain, bleeding, or both were classified as definite or probable intrauterine or ectopic pregnancies or as nondiagnostic pregnancie…