What tests are done to rule out ectopic pregnancy

Ectopic pregnancy is a very common disease that endangers the health of female friends. Once it occurs, surgical treatment must be taken. Other conservative treatments are not so effective for this disease, and a lot of examinations are required. These examinations are to better rule out the possibility of ectopic pregnancy. If the test results are abnormal, you can only get corresponding treatment to prevent your body from being too harmful.

examine:

1. Posterior fornix puncture for ectopic pregnancy. Since blood in the abdominal cavity is most likely to accumulate in the rectouterine pouch, even if the amount of blood is not large, it can be sucked out through the posterior fornix puncture. Use an 18-gauge long needle to pierce the posterior fornix of the vagina into the rectouterine pouch and draw out dark red non-coagulated blood. This is a positive result, and the result indicates that there is blood accumulation in the abdominal cavity during the posterior fornix puncture.

2. For ectopic pregnancy test, when the embryo is alive or the trophoblast cells are viable, the syncytial cells secrete hCG and the pregnancy test may be positive. Since the hCG level in patients with ectopic pregnancy is relatively normal and is low during pregnancy, the general hCG determination method has a low positive rate and a more sensitive β-hCg radioimmunoassay or monoclonal antibody enzyme-labeled method must be used for detection.

3. Ultrasound diagnosis of ectopic pregnancy. In the early stage of tubal pregnancy, B-ultrasound can show an enlarged uterus, 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. The possibility of early intrauterine pregnancy with corpus luteum should be ruled out. Ultrasound detection of gestational sac and fetal heart beat is very important for diagnosing ectopic pregnancy. If the pregnancy is outside the uterus, it can be diagnosed as ectopic pregnancy.

4. Laparoscopic examination of ectopic pregnancy: Laparoscopic examination can be used if conditions permit and when necessary.

5. Pathological examination of the endometrium in ectopic pregnancy. Diagnostic curettage is only suitable for patients with heavy vaginal bleeding, and its purpose is to exclude intrauterine pregnancy and uterine discharge. The sections should be sent for pathological examination routinely. If chorionic villi are seen, it can be diagnosed as intrauterine pregnancy. If only decidua are seen without villi, ectopic pregnancy should be considered but cannot be confirmed.

Tubal pregnancy: Tubal pregnancy accounts for about 95% of ectopic pregnancies, among which ampulla pregnancy is the most common, accounting for about 78%, followed by isthmus and fimbria pregnancy, and interstitial pregnancy is less common. The typical symptoms of tubal pregnancy are abdominal pain and vaginal bleeding after menstruation. The patient may also have an abdominal mass or even fainting and shock.

Ovarian pregnancy: Ovarian pregnancy refers to the implantation and development of the fertilized egg in the ovary, with an incidence rate of 1:7000-1:50000. The clinical manifestations of ovarian pregnancy are very similar to those of fallopian tube pregnancy, with the main symptoms being amenorrhea, abdominal pain and vaginal bleeding.

Abdominal pregnancy: Abdominal pregnancy refers to the location of the embryo or fetus in the abdominal cavity outside the fallopian tubes, ovaries and broad ligaments. Patients experience amenorrhea and early pregnancy reactions, and most have symptoms of unexplained anemia in early pregnancy, accompanied by abdominal pain and vaginal bleeding. Then the vaginal bleeding stops and the abdomen gradually enlarges. Pregnant women often feel abdominal pain during fetal movement, and the symptoms gradually worsen as the fetus grows.

Cervical pregnancy: When the fertilized egg implants and develops in the cervical canal, it is called cervical pregnancy. The main symptoms are painless vaginal bleeding or bloody discharge. The amount of bleeding usually increases from a little to a lot, but it can also be intermittent heavy vaginal bleeding.