Auxiliary examination methods for ectopic pregnancy

Ectopic pregnancy is a common gynecological acute abdomen. When miscarriage or rupture does not occur, the clinical manifestations are not obvious and the diagnosis is difficult. Auxiliary examinations should be combined to make a clear diagnosis as soon as possible.

Hormone level measurement

1. Human chorionic gonadotropin measurement is currently an important method for early diagnosis of ectopic pregnancy;

2. Progesterone measurement. The serum progesterone level of patients with ectopic pregnancy is low, but it is relatively stable at 5 to 10 weeks of pregnancy. A single measurement has a great diagnostic value. Although there is overlap between normal and abnormal pregnancy serum progesterone levels, it is difficult to determine the absolute critical value between them, but serum progesterone levels below 10ng/ml often indicate ectopic pregnancy, and its accuracy rate is about 90%.

Ultrasound diagnosis

Type B ultrasound examination is particularly commonly used for the diagnosis of ectopic pregnancy, and vaginal ultrasound examination is more accurate than abdominal ultrasound examination.

Diagnostic curettage

When ectopic pregnancy cannot be ruled out, diagnostic curettage can be performed to obtain the endometrium for pathological examination. However, the endometrial changes in ectopic pregnancy are not characteristic and can be manifested as decidual tissue, highly secretory phase with or without A-S reaction, secretory phase and proliferative phase. Endometrial changes are related to whether the patient has vaginal bleeding and the duration of vaginal bleeding. Therefore, the diagnosis of ectopic pregnancy by diagnostic curettage alone has great limitations.

Posterior fornix puncture

Posterior uterine fornix puncture is widely used to assist in the diagnosis of ectopic pregnancy. Blood can often be drawn out and placed without coagulation, and there are small clots in it. If no liquid is drawn out, the diagnosis of ectopic pregnancy cannot be ruled out.

Laparoscopy

For some cases that are difficult to diagnose, examination under direct laparoscopy can provide a clear diagnosis in a timely manner and allow for simultaneous surgical treatment.