Ectopic Pregnancy

Definition:

• Ectopic pregnancy is defined as pregnancy outsied the uterine cavity
• Most common site of occurrence is the fallopian tube

Etiology:

• Salpingitis
• Pelvic inflammatory disease
• Intrauterine device usage

Symptoms:

• Abnormal uterine bleeding approximately 1-2 weeks after the missed menstrual period
• Lower abdominal pain

Tests:

• Urine pregnancy test-may be negative
• Ultrasound
• Serial serum B-hCG testing:
• -ELISA method - a quantative measurement which measures the serum B-hCG
• -Results can be used to detect pregnancy; monitor the progress; help in establishing the estimated gestational age; detect levels of HCG which can occur in conditions not related to pregnancy, ex: gestational trophoblastic disease
• Results reported in mIU/ml (milliInternational units per milliliter)
• Rate of B-hCG rise in serum in a normal pregnancy:
• -doubles every two days
• -detectable within 24-48 hours after implantation
• -peaks in 10 weeks after last menstrual period
• Ectopic pregnancy is associated with an impaired HCG production
• an increase in serum B-hCG less than 66% over two days is predictive of ectopic pregnancy
• Correlate lab results with the clinical picture to establish the diagnosis

1. Bakerman, Seymour, MD, PhD; ABC's of Interpretive Laboratory Data
2. Beck, William Jr,; Obstetrics and Gynecology