Routine examination methods for ectopic pregnancy

Ectopic pregnancy refers to the placement of the fertilized egg outside the uterine cavity. It must be treated in time, otherwise it will pose a threat to life safety. The prerequisite for treatment is to conduct examinations to obtain a confirmed diagnosis.

1. Posterior fornix puncture

The positive rate of posterior fornix puncture is over 90%, which is a traditional simple and rapid diagnostic method for intra-abdominal bleeding. Generally, an 18-gauge spinal needle is used to quickly puncture the rectouterine pouch from the posterior fornix of the vagina. The dark red blood drawn out will not coagulate, because ectopic pregnancy, miscarriage or rupture bleeding stimulates the peritoneum to produce a fibrinolytic activator-plasminogen activator, which converts the plasminogen in the blood into plasmin, which can hydrolyze plasma proteins and coagulation factors, so that the blood will no longer coagulate.

2. Progesterone determination

The progesterone level of patients with ectopic pregnancy is significantly low, so progesterone testing can provide a diagnostic basis for ectopic pregnancy. The serum level of all ectopic pregnancy patients in early pregnancy is lower than 5ng/ml. Developed countries have listed progesterone testing as a routine examination after pregnancy, which significantly improves the early diagnosis rate of ectopic pregnancy.

3. Imaging of the accessory area

The imaging of ectopic pregnancy depends on the size of the ectopic mass, whether there is rupture, miscarriage and intra-abdominal bleeding. In patients with unruptured ectopic pregnancy, a complete gestational sac with a fetal bud can be seen in the adnexal area. In patients with later pregnancy, fetal heartbeats can sometimes be seen. In most patients, the adnexal area presents a cystic or mixed mass, which needs to be carefully identified from the ovary and differentiated from ovarian cysts, cysts or intestinal loops.