Abstract: Objective To investigate the diagnostic value of vaginal ultrasound in tubal pregnancy and to observe the effect of conservative treatment with methotrexate versus laparoscopic treatment. 
Methods Ninety-four patients with tubal pregnancy admitted to our hospital were retrospectively selected to undergo vaginal ultrasound(vaginal ultrasound group) and abdominal ultrasound(abdominal ultrasound group), and the 94 patients were divided into two subgroups according to the treatment modality, including 45 cases in the methotrexate group and 49 cases in the laparoscopic group. The diagnostic value of vaginal ultrasound for tubal pregnancy was compared, and the efficacy of conservative treatment with methotrexate versus laparoscopic treatment on tubal pregnancy was analyzed. 
Results The positive rates of ultrasound imaging findings such as intrauterine pseudopregnancy sac, adnexal mass, pregnancy germ, yolk sac, and heart bud pulsation were 37.23%, 94.68%, 42.55%, 47.87% and 12.77% respectively, which were higher than 15.96%, 76.60%, 18.09%, 26.60% and 10.64% by abdominal ultrasound, suggesting significant differences(P＜0.05). The diagnostic accuracy of transvaginal ultrasound was 92.55%, which was higher than that(76.60%) of abdominal ultrasound(P＜0.05). The length of hospitalization and the recovery time of human chorionic gonadotropin(hCG) in the laparoscopic group were significantly shorter than those in the methotrexate group, and the incidence of abdominal pain was higher than that in the methotrexate group, suggesting significant differences(P＜0.05). At 1 year after treatment, the intrauterine pregnancy rate in laparoscopic group was lower than that in methotrexate group, suggesting significant differences(P＜0.05), but there was no significant difference in tubal pregnancy again between two groups(P＞0.05). 
Conclusion Vaginal ultrasound has a high diagnostic value for tubal pregnancy, while conservative treatment with methotrexate and laparoscopic treatment have certain therapeutic effects on tubal pregnancy, and each has its own advantages. The clinical choice can be made based on treatment needs.

Key words: pregnancy, tubal, ultrasonography, methotrexate, laparoscopy