Symptoms and Signs of Ectopic Pregnancy Ectopic Pregnancy
There is often unilateral pain in the lower abdomen or pelvis and vaginal bleeding. The pain and bleeding may be continuous or intermittent, and in some cases, there may be no symptoms at all. High-risk factors for ectopic pregnancy include tubal surgery, tubal sterilization, a history of ectopic pregnancy, exposure to diethylstilbestrol (DES) in utero, use of an intrauterine device (IUD), and documented tubal disease. Tubal sterilization and other procedures can cause blockages where the embryo becomes trapped and cannot travel to implant in the uterine cavity. An IUD prevents intrauterine pregnancy but does not prevent ectopic pregnancy. Generally, the chance of pregnancy after sterilization or IUD insertion is very low due to their high effectiveness as contraceptive methods, but if pregnancy occurs, the likelihood of it being ectopic is higher than normal.
Diagnosis Besides symptoms, history, and physical examination, the diagnosis of ectopic pregnancy can be made by taking a history of pregnancy symptoms such as missed periods, morning sickness, nausea, breast tenderness, frequent urination, etc. Physical and internal examinations, pregnancy hormone tests, and ultrasound examinations are also used. The three criteria for ectopic pregnancy are missed periods, lower abdominal pain, and bleeding, along with a tender mass found in the adnexa. If all three criteria are present, ectopic pregnancy can be diagnosed with 90% accuracy. In cases where high levels of pregnancy hormones are detected and ultrasound does not show a gestational sac in the uterine cavity, it strongly indicates an ectopic pregnancy. If the ultrasound clearly shows a gestational sac with an embryo outside the uterine cavity, it is the most accurate diagnosis, but such clear cases are rare, and some facilities may not have ultrasound equipment.
However, early-stage ectopic pregnancy can be difficult to diagnose. Some women may not show any abnormal symptoms, and even experts can misdiagnose. Many ectopic pregnancies are diagnosed retrospectively and cannot be diagnosed on the first visit. Multiple visits to the doctor, repeated pregnancy hormone tests, and multiple ultrasounds may be necessary. Every pregnancy could be ectopic until proven otherwise.
Source: Unplanned Pregnancy Network Book