Ectopic pregnancy occurs in nearly 3 percent of all pregnancies. If not accurately diagnosed early in their pregnancies, 6 percent of these mothers die.
In this week’s Journal of the American Medical Association, Dr. Lori Bastian, professor of medicine at the UConn Health Center, reviewed dozens of cases of pregnant women with abdominal pain or vaginal bleeding early in their pregnancy.
Bastian, along with Drs. John Crochet and Monique Chireau of Duke University Medical Center, found that “patient history and clinical examination alone are insufficient to indicate or eliminate the possibility of ectopic pregnancy. In a hemodynamically stable patient, the appropriate evaluation includes transvaginal sonography and quantitative (serial) serum hCG testing. Patients with signs and symptoms of excessive blood loss or hemodynamic collapse should immediately have gynecological evaluation.”
The authors stress in the article that the rapid identification and accurate diagnosis of women who may have an ectopic pregnancy is critically important for reducing the maternal morbidity and mortality associated with this condition. They conclude that “the presence of abdominal pain or vaginal bleeding during early pregnancy should prompt a transvaginal sonogram and quantitative serum hCG testing.”
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