Ectopic Pregnancy - Diagnosis

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How is ectopic pregnancy diagnosed?

The first step in the diagnosis is an interview and examination by the doctor. The usual second step is to obtain a qualitative (positive or negative for pregnancy) or quantitative (measures hormone levels) pregnancy test. Occasionally, the doctor may feel a tender mass during the pelvic examination. If an ectopic pregnancy is suspected, the combination of blood hormone pregnancy tests and pelvic ultrasound can usually help to establish the diagnosis. Transvaginal ultrasound is the most useful test to visualize an ectopic pregnancy. In this test, an ultrasound probe is inserted into the vagina, and pelvic images are visible on a monitor. Transvaginal ultrasound can reveal the gestational sac in either a normal (intrauterine) pregnancy or an ectopic pregnancy, but often the findings are not conclusive. Rather than a gestational sac containing a visible embryo, the examination may simply reveal a mass in the area of the Fallopian tubes or elsewhere that is suggestive of, but not conclusive for, an ectopic pregnancy. The ultrasound can also demonstrate the absence of pregnancy within the uterus.

Pregnancy tests are designed to detect specific hormones; the beta subunit of human chorionic gonadotrophin (beta HCG) blood levels are also used in the diagnosis of ectopic pregnancy. Beta HCG levels normally rise during pregnancy. An abnormal pattern in the rise of this hormone can be a clue to the presence of an ectopic pregnancy. In rare cases, laparoscopy may be needed to ultimately confirm a diagnosis of ectopic pregnancy. During laparoscopy, viewing instruments are inserted through small incisions in the abdominal wall to visualize the structures in the abdomen and pelvis, thereby revealing the site of the ectopic pregnancy.

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See what others are saying

Comment from: kristag, 35-44 Female (Patient) Published: November 25

I didn't even have a clue I was pregnant. I woke up and thought I had gas pain. The pain got progressively worse throughout the day until, about 5 hours later I was literally writhing on the floor with pain. My friend took me to the emergency room, they informed me that a urine pregnancy test came back positive and that they would send me home to let it "resolve itself". I refused and asked for a second opinion. The second doctor agreed to admit me, I was in the worst pain I have ever experienced! Later that evening after being admitted, they checked my hemoglobin and realized that I was bleeding internally and rushed to emergency surgery. I would have surely bled to death internally because I ruptured my tube, thank goodness I insisted on being admitted.

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Comment from: jms, 25-34 Female (Patient) Published: July 24

I was trying to get pregnant with second child. I noticed that I had a little bleeding. I was also a little nauseous. A few times when I was sitting quietly I felt a little twitching in my side. It felt the way my eye does if I get a twitch. I found that I was pregnant from a home test. My doctor wanted to see me due to the spotting. I suggested ectopic and they said I looked too 'good' to have an ectopic. I should have been in a lot of pain. I insisted they give me a sonogram and found that I was. I had surgery the following day and they needed to remove one of my tubes. I was so scared that I would get pregnant again. They had me wait 3 months before I could try. After the second month of trying I was pregnant! He was a very healthy little boy.

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