Ectopic pregnancy is a common yet dangerous gynecological condition. It's like a ticking time bomb that can pose risks at any moment. Without early detection and treatment, it may become life-threatening, making prompt diagnosis crucial.
How is ectopic pregnancy diagnosed?
Expert note: Early ectopic pregnancy mimics normal pregnancy with missed periods, but ultrasound scans and blood tests reveal abnormalities.
1. Ultrasound Diagnosis: Shows an enlarged uterus with an empty cavity and a hypoechoic area beside the uterus.
2. Blood HCG Test: Currently one of the key methods for early diagnosis of ectopic pregnancy.
3. Posterior Fornix Puncture: May reveal intra-abdominal hemorrhage, indicating a possible ectopic pregnancy.
4. Laparoscopy: The most precise diagnostic method. Laparoscopy is the most advanced equipment available, capable of both treatment and examination with the highest accuracy. For difficult-to-diagnose cases, laparoscopy enables timely confirmation of diagnosis and simultaneous surgical intervention.
5. Hysteroscopy: When feasible and necessary, hysteroscopic examination may be performed. If previous tests suggest polycystic ovaries or masses, hysteroscopy is used for definitive diagnosis. This procedure carries higher costs.
6. Endometrial Pathology Examination: Diagnostic curettage is only applicable for patients with heavy vaginal bleeding, aiming to rule out intrauterine pregnancy. The expelled endometrial tissue should routinely undergo pathological examination. The presence of villi confirms intrauterine pregnancy. If only decidua is observed without villi, ectopic pregnancy should be considered but cannot be definitively diagnosed.
Steps for evaluating ectopic pregnancy:
【Abdominal Pain】
Lower abdominal heaviness with a sensation of needing to defecate, sometimes severe pain accompanied by cold sweats. Rupture causes sudden, tearing pain on one side of the lower abdomen, often with nausea and vomiting.
【Amenorrhea】
Before tubal pregnancy miscarriage or rupture, symptoms and signs are often subtle. Beyond brief amenorrhea and pregnancy-related manifestations, some may experience unilateral lower abdominal distension and pain. Examination may reveal normal or enlarged fallopian tubes.
【Vaginal Bleeding】
Typically presents as light bleeding.
【Syncope and Shock】
Acute intra-abdominal hemorrhage can cause hypovolemia and severe abdominal pain. Mild cases often present with syncope, while severe cases may develop shock.
【Other Symptoms】
May include nausea, vomiting, and frequent urination. Ectopic pregnancy symptoms are often atypical; some patients experience shock from massive hemorrhage, presenting with pallor and hypotension.