DIAGNOSTIC ACCURACY OF TRANSVAGINAL ULTRASOUND WITH COLOR DOPPLER IN DIFFERENTIATING BENIGN VS MALIGNANT ADNEXAL MASSES IN PREGNANCY

Abstract

Background: Adnexal masses are increasingly detected during pregnancy due to the widespread use of routine obstetric ultrasonography. Transvaginal ultrasonography (TVUS) combined with Color Doppler imaging has become the preferred first-line imaging modality. Objective: To determine the diagnostic accuracy of transvaginal ultrasonography combined with Color Doppler in differentiating benign from malignant adnexal masses during pregnancy using histopathological examination as the reference standard. Methods: A prospective observational diagnostic accuracy study was conducted among pregnant women diagnosed with adnexal masses at a tertiary care teaching hospital. Eligible participants who underwent transvaginal ultrasonography with Color Doppler evaluation were consecutively enrolled. Sonographic characteristics were systematically documented. The diagnostic performance of TVUS combined with Color Doppler was evaluated by calculating sensitivity, specificity, positive predictive value, negative predictive value and overall diagnostic accuracy. Results: A total of 132 pregnant women with sonographically diagnosed adnexal masses were included in the study. Histopathological examination identified 118 (89.4%) benign and 14 (10.6%) malignant lesions. The imaging modality demonstrated a sensitivity of 92.9%, specificity of 95.8%, positive predictive value of 72.2%, negative predictive value of 99.1%, and an overall diagnostic accuracy of 95.5%. Conclusion: Transvaginal ultrasonography combined with Color Doppler demonstrated excellent diagnostic performance in differentiating benign from malignant adnexal masses during pregnancy. As a safe, non-invasive, readily available, and cost-effective imaging modality, TVUS with Color Doppler can support timely referral, individualized clinical management, and improved maternal and fetal outcomes.