How to determine whether it is an ectopic pregnancy?

Since ectopic pregnancy can pose a great threat to the health of women and fetuses, no matter who you are, you should pay attention to understand and judge whether it is an ectopic pregnancy. Common methods include urine pregnancy test, blood progesterone measurement and ultrasound examination.

(1) Urine pregnancy test: simple and quick. A positive result can assist in diagnosis, while a negative result requires waiting for blood β-HCG quantification to rule it out.

(2) Quantification of blood β-HCG: It is an important method for early diagnosis of ectopic pregnancy. In addition to assisting in diagnosis, it can also help determine the activity of the embryo to guide treatment. In ectopic pregnancy, the blood β-HCG level is usually lower than that in normal intrauterine pregnancy. After conservative medical treatment or surgery, monitor blood beta-HCG levels to detect persistent ectopic pregnancy early.

(3) Blood progesterone measurement: The progesterone level in patients with ectopic pregnancy is relatively low, which can also be used as an indicator for diagnosing early ectopic pregnancy. The progesterone value in early pregnancy is relatively stable. For example, if the progesterone value is <45nmol/L (15ng/ml) at 8 weeks of pregnancy, it indicates ectopic pregnancy or corpus luteum hypoplasia, with a sensitivity of 95%. There is overlap in the serum progesterone levels of normal and abnormal pregnancy, and it is difficult to determine the absolute critical value between them. It is for reference only. Developed countries include progesterone as a routine monitoring indicator for ectopic pregnancy.

(4) Ultrasound examination: Vaginal ultrasound is superior to abdominal ultrasound, with an accuracy rate of 70% to 94% for diagnosing ectopic pregnancy. The diagnosis can be confirmed by seeing a gestational sac ("fallopian tube ring") or fetal heartbeat in the fallopian tube. For those with a history of cesarean section, the anterior wall scar should be observed in particular to avoid missing the diagnosis of scar pregnancy. If the serum β-HCG level exceeds 2000mIU/ml, if it is an intrauterine pregnancy, vaginal ultrasound can detect the gestational sac; otherwise, one should be alert to ectopic pregnancy. Fluid dark areas in the pelvic and abdominal cavities are helpful for diagnosis.