Diagnosis of Ectopic Pregnancy
The diagnosis of ectopic pregnancy involves confirming that a pregnancy exists, and then determining whether it is located inside or outside the uterus. Because ectopic pregnancy can look similar to a normal early pregnancy, diagnosis requires careful testing and sometimes several visits to confirm the findings.
The process often begins with a positive pregnancy test, followed by a thorough review of symptoms. A woman who presents with pelvic pain, abnormal bleeding, or fainting in early pregnancy is always evaluated for a possible ectopic pregnancy.
The most common and reliable method of diagnosis is transvaginal ultrasound. This imaging technique allows doctors to look inside the pelvis and check whether a gestational sac is present in the uterus. If the uterus is empty, and the pregnancy hormone (hCG) levels are high enough that a pregnancy should be visible, doctors may suspect an ectopic pregnancy.
However, not all ectopic pregnancies are visible on ultrasound right away. In these cases, doctors monitor hCG levels through blood tests over several days. Furthermore, in a normal pregnancy, hCG levels roughly double every 48 hours. In an ectopic pregnancy, the rise is usually slower or may plateau. This pattern, combined with an empty uterus on ultrasound, strengthens the diagnosis.
If the ectopic pregnancy is large enough, it may appear on the ultrasound as a mass in the fallopian tube or as free fluid in the abdomen, indicating internal bleeding. These findings confirm the diagnosis and help guide the urgency of treatment.
Diagnosis of Ectopic Pregnancy
In rare cases, diagnostic surgery called laparoscopy may be needed. This minimally invasive procedure allows doctors to directly view the pelvic organs and confirm the location of the pregnancy. It’s often used when imaging results are inconclusive but symptoms are worsening.
In South Africa, access to early pregnancy scans and blood testing can be limited in rural areas. As a result, ectopic pregnancies are sometimes diagnosed only after rupture has occurred. This makes investment in early antenatal care and patient education critically important.
The diagnosis of ectopic pregnancy is time-sensitive. A delayed diagnosis can lead to tubal rupture, severe bleeding, and permanent damage to reproductive organs. Early detection allows for more treatment options and reduces the risk of serious complications.
[Next: Treatment of Ectopic Pregnancy →]
