©Pregnancy bliss 2008
Diagnosing ectopic pregnancy
When a woman has symptoms described above in early pregnancy, two essential tests (in addition to physical examination) will be done:
§ A urine pregnancy test and
§ A pelvic ultrasound scan
Physical examination may reveal features that may strengthen the doctor's suspicion of an ectopic pregnancy but will not normally conclusively establish the diagnosis.
If the pregnancy test is positive, this is where an ultrasound scan comes in. If the scan shows the pregnancy in the womb, then an ectopic pregnancy is most unlikely. If the womb is empty, it does strongly suggest an ectopic pregnancy. It is, however, not a foregone conclusion. The doctor has to look at the whole picture before reaching a firm diagnosis.
Empty uterus (on a scan) and a positive pregnancy test
This scenario does not necessarily amount to an ectopic pregnancy. An "empty" uterus may be because there was a pregnancy there that has since miscarried. Alternatively, there may be a pregnancy there that is still too small to be detected on the scan. Remember, a pregnancy less than 5 weeks will not be visible on the scan.
Detecting a tubal pregnancy using ultrasound scan
This will be ideal as it will remove any doubts. Unfortunately, seeing an ectopic pregnancy on the scan is an exception rather than the rule. In most cases, the diagnosis is reached by exclusion and piecing the evidence together. It is not unusual to conclude that the diagnosis is an ectopic pregnancy, take the patient to theatre, only to find no ectopic.
Treatment options for Ectopic Pregnancy
Once a diagnosis of ectopic pregnancy has been established patient, depending on her condition, will be offered two broad options:
· Surgical treatment
· Medication
Most patients are offered the surgical option. She will be taken to theatre as an emergency. If there is still some doubt, a diagnostic laparoscopy is performed. If the diagnosis is confirmed, the pregnancy is removed, either by opening the tube or by removing the entire affected tube with the pregnancy inside.
Opening the tube to remove the pregnancy (thus conserving the tube) is called salpingostomy. Removal of the tube with its contents is called salpingectomy
The procedure is in many cases done entirely laparoscopically (by keyhole surgery)
and the woman is able to leave hospital within twenty-
Sometimes, the keyhole approach is not technically possible, which means the abdomen
has to be opened. This will mean a longer (3-