Radiographic features • beta HCG prior to scanning • at levels <2000 IU, a normal early pregnancy may not be visible. Ultrasound The ultrasound exam should be performed both transabdominal and transvaginally. The transabdominal component provides Positive sonographic findings include: uterus • an empty uterine cavity or no evidence of an intrauterine pregnancy • pseudogestational sac or decidual cyst current evidence suggests that one should not initiate treatment for ectopic pregnan • decidual cast • thick echogenic endometrium tube and ovary • complex extra-adnexal cyst/mass • solid hyperechoic mass is possible but non-specific • tubal ring sign • ring of fire sign • free pelvic fluid or hemoperitoneum in the pouch of Douglas