How is it Diagnosed?
Ectopic pregnancy, where a fertilized egg implants outside the uterine cavity—
commonly in the fallopian tube—is diagnosed through a combination of clinical
evaluation, imaging, and laboratory tests. Symptoms typically include lower abdominal
pain, vaginal bleeding, and sometimes shoulder pain or fainting due to internal bleeding.
A pregnancy test (urine or serum hCG) confirms pregnancy. However, the gold standard
for diagnosing ectopic pregnancy is transvaginal ultrasound. In a normal intrauterine
pregnancy, a gestational sac should be visible within the uterus when β-hCG levels
reach 1,500–2,000 mIU/mL. If the uterus appears empty and hCG levels are above this
threshold, suspicion of ectopic pregnancy rises.
Ultrasound may show an adnexal mass, free fluid in the pelvis, or a gestational sac
outside the uterus. Serial β-hCG measurements are also useful; in a viable pregnancy,
levels typically double every 48–72 hours. In ectopic pregnancies, this rise is slower or
plateaued.
If imaging is inconclusive, diagnostic laparoscopy may be performed to directly visualize
and treat the ectopic site. Early diagnosis is essential to prevent tubal rupture and
internal hemorrhage, which can be life-threatening. Management options include
methotrexate therapy for early cases or surgical intervention for unstable patients.