| Abstract: | Early diagnosis of ectopic pregnancy has been greatly improved by three diagnostic advances: the development of rapid and highly sensitive pregnancy tests, advances in ultrasound examination, and laparoscopy. The estimation of hCG is clinically superior to the measurement of any other pregnancy protein or biochemical parameter. If an hCG test has a sensitivity of 25 IU/1, then 90-100% of ectopic pregnancies will give a positive result. But, the hCG test cannot distinguish between intrauterine and ectopic pregnancy, and here ultrasonic examination and laparoscopy are routine diagnostic measures to identify the site of trophoblastic activity. If highly sensitive hCG tests are used routinely, they may detect small amounts of hCG so early in ectopic pregnancy that the tubal swelling is missed, or hCG may be reminiscent from trophoblastic activity of a previous regressing intrauterine or ectopic pregnancy. The lesson we learn from such cases is that a patient with an elevated hCG level in whom an intrauterine pregnancy has been excluded should be carefully followed-up as long as hCG remains elevated because of the possibility of an early ectopic pregnancy. |
