Common methods for diagnosing ectopic pregnancy

Ectopic pregnancy refers to pregnancy outside the uterine cavity, most commonly in the fallopian tube. Ectopic pregnancy is a dangerous gynecological acute abdomen. There are several diagnostic methods:

Posterior fornix puncture

Use an 18-gauge long needle to puncture the rectouterine pouch from the posterior vaginal fornix, and draw out dark red, non-coagulated blood, which is a positive result, indicating the presence of intra-abdominal blood. Since intra-abdominal blood is most likely to accumulate in the rectouterine pouch, even if the amount of blood is small, it can be sucked out through the posterior fornix puncture.

Pregnancy test

When the embryo survives or the trophoblast cells are viable, the syncytial cells secrete human chorionic gonadotropin, and the pregnancy test may be positive. Since the level of human chorionic gonadotropin in patients with ectopic pregnancy is lower than that in normal pregnancy, the general human chorionic gonadotropin determination method has a low positive rate, and a more sensitive β-human chorionic gonadotropin radioimmunoassay or monoclonal antibody enzyme-labeled method must be used for detection.

Ultrasound diagnosis

In the early stage of tubal pregnancy, B-ultrasound imaging shows that the uterus is enlarged, but the uterine cavity is empty, and there is a low echo area next to the uterus. This image is not the acoustic feature of tubal pregnancy, and the possibility of early intrauterine pregnancy with corpus luteum should be excluded. Using ultrasound to detect the gestational sac and fetal heartbeat is very important for diagnosing ectopic pregnancy. If the pregnancy is outside the uterus, it can be diagnosed as ectopic pregnancy.

Endometrial examination

Diagnostic curettage is only suitable for patients with heavy vaginal bleeding, and its purpose is to exclude intrauterine pregnancy. Uterine discharge should be routinely sent for pathological examination. If villi are seen in the slice, intrauterine pregnancy can be diagnosed. If only decidua is seen without villi, ectopic pregnancy should be considered, but it cannot be confirmed.

Laparoscopy

Laparoscopic examination can be performed for patients with suspected ectopic pregnancy if conditions permit and if necessary.