How to rule out ectopic pregnancy?

The main clinical symptom of ectopic pregnancy is abdominal pain, so many people confuse it with other diseases. Generally, the abdominal pain of ectopic pregnancy mainly shifts from the chest area to the right lower abdomen, and there is bleeding. So how to check it specifically?

1. HCG determination for early diagnosis: HCG detection is currently an important method for early diagnosis of ectopic pregnancy. Enzyme-linked immunosorbent assay is commonly used in clinical practice to determine urine β-HCG. The method is simple and rapid and is suitable for emergency patients. However, this method is a qualitative test with low sensitivity.

2. Ultrasound diagnosis: Although the uterus is enlarged, the uterine cavity is empty and a low-echo area appears beside the uterus. If the embryo and primitive heart tube pulsation are found in this area, ectopic pregnancy can be confirmed. Type B ultrasound imaging can usually only detect the embryo and primitive heart tube pulsation after 7 weeks of menopause. Diagnosis of early ectopic pregnancy may sometimes be wrong based on B-mode ultrasound imaging alone. If it can be combined with clinical manifestations and β-HCG determination, it will be of great help in diagnosis.

3. Laparoscopic examination: If conditions permit and it is necessary, laparoscopic examination can be used to examine ectopic pregnancy. Examination and treatment can be carried out at the same time to avoid secondary injury and better protect fertility.

4. Posterior vaginal fornix puncture: Posterior vaginal fornix puncture is a simple and reliable diagnostic method, suitable for patients suspected of intra-abdominal bleeding. It is known that intra-abdominal bleeding is most likely to accumulate in the rectouterine pouch. Even if the amount of blood is not large, blood can be drawn out by puncturing the posterior vaginal fornix. The extraction of dark red, non-coagulated blood indicates the presence of hemoabdomen. In the case of old ectopic pregnancy, small blood clots or uncoagulated old blood can be drawn out. If the puncture needle enters the vein by mistake, the blood will be redder and the specimen will coagulate after being left for about 10 minutes.