Diagnosis and Differentiation of Ectopic Pregnancy

Diagnosis and Differentiation of Ectopic Pregnancy

1. Threatened abortion in early pregnancy

The abdominal pain of threatened abortion is generally mild, the size of the uterus is basically consistent with the month of pregnancy, the amount of vaginal bleeding is small, and there is no internal bleeding. B-ultrasound can be used for identification.

2. Ovarian corpus luteum rupture and bleeding

Corpus luteum rupture often occurs during the luteal phase or menstrual period. However, it is sometimes difficult to differentiate from ectopic pregnancy, especially in patients with no obvious history of amenorrhea and irregular vaginal bleeding, and β-HCG is often required for diagnosis.

3. Ovarian cyst pedicle torsion

The patient has normal menstruation, no signs of internal bleeding, and generally has a history of adnexal masses. The cyst pedicle may have obvious tenderness. The diagnosis can be confirmed by gynecological examination combined with B-ultrasound.

4. Rupture and bleeding of ovarian chocolate cyst

The patient has a history of endometriosis, which often occurs before or during menstruation. The pain is quite severe and may be accompanied by obvious anal swelling. Chocolate-like liquid can be extracted by puncturing the posterior vaginal fornix for diagnosis. If the rupture injures the blood vessels, signs of internal bleeding may occur.

5. Acute pelvic inflammatory disease

In acute or subacute inflammation, there is generally no history of amenorrhea, abdominal pain is often accompanied by fever, blood count and erythrocyte sedimentation rate are often elevated, B-ultrasound can detect adnexal masses or pelvic effusion, and urine HCG can assist in diagnosis. Especially after anti-inflammatory treatment, inflammatory manifestations such as abdominal pain and fever can gradually alleviate or disappear.

6. Surgical conditions

Acute appendicitis often causes obvious right lower abdominal pain, often accompanied by fever, nausea, vomiting, and increased blood count. Ureteral stones often cause colic pain on one side of the lower abdomen, accompanied by ipsilateral lumbar pain and hematuria. The diagnosis can be confirmed by combining B-ultrasound and X-ray examinations.