In evaluating suspected ectopic pregnancy in a hemodynamically stable patient, which imaging modality is preferred?

• A. Transvaginal ultrasound
• B. Abdominal X-ray
• C. CT abdomen
• D. MRI

Answer: (A)

The main idea here is that the imaging test chosen first for a suspected ectopic pregnancy in a stable patient is the transvaginal ultrasound. This modality gives high-resolution images of the uterus and adnexa, allowing you to determine whether a pregnancy is intrauterine or ectopic, identify an adnexal mass, and assess for free fluid that could signal rupture. It can detect pregnancy very early and does so with minimal or no radiation, which is safer for the patient and the fetus.

Abdominal X-ray isn’t helpful for locating a pregnancy and exposes the patient to radiation without providing useful information about implantation site. CT abdomen also involves radiation and is not the preferred initial test for early pregnancy evaluation. MRI can be safe and helpful in specific cases, but it’s not the first-line tool due to cost, availability, and practicality in acute evaluation.