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Ectopic Pregnancy: Diagnostic Aspects

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Implantation

Abstract

Ectopic pregnancies can be divided into three clinical groups. In the first group, with clear evidence of haemoperitoneum, the only investigation needed is laparoscopy or occasionally laparotomy. In the second group, with a less acute presentation (positive pregnancy test, abdominal pain), the diagnosis is aided by a high index of suspicion and a few additional diagnostic tests. The third group includes women at high risk of ectopic gestation (subfertile patients with a past history of ectopic gestation or tubal surgery and those attending for in-vitro fertilisation (IVF) or gamete intrafallopian transfer (GIFT).

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References

  • Abramovici H, Auslender R, Lewis A, Faktor JH (1983) Gestational-pseudogestational sac: a new ultrasonic criterion for differential diagnosis. Am J Obstet Gynecol 145: 377–379

    PubMed  CAS  Google Scholar 

  • Ackerman R, Deutsche S, Krumholz B (1982) Levels of hCG in unruptured and ruptured ectopic pregnancy. Obstet Gynecol 60: 13–14

    PubMed  CAS  Google Scholar 

  • Armstrong JT, Wills, SH, Moore J, Lauden AE (1959) Ectopic pregnancy: a review of 481 cases. Am J Obstet Gynecol 77: 364–370

    PubMed  CAS  Google Scholar 

  • Bell JW, Ingersoll FM (1950) An evaluation of the symptoms and signs in ectopic pregnancy, based on an analysis of 130 cases. Am J Obstet Gynecol 60: 174–179

    PubMed  CAS  Google Scholar 

  • Bischof P, Reyes Y, Herrmann WL, Sizonenko PC (1983) Circulating levels of PAPP-A and hCG in intrauterine and extrauterine pregnancies. Br J Obstet Gynaecol 90: 323–325

    Article  PubMed  CAS  Google Scholar 

  • Biswas S, Rodeck CH (1976) Plasma prolactin levels during pregnancy. Br J Obstet Gynaecol 83: 683–687

    Article  PubMed  CAS  Google Scholar 

  • Bradley WG, Fiske CE, Filly RA (1982) The double sac sign of early intrauterine pregnancy: use in exclusion of ectopic pregnancy. Radiology 143: 223–226

    PubMed  CAS  Google Scholar 

  • Braunstein GO, Asch HR (1983) Predictive value analysis of measurements of hCG, SP1, hPL and cystine aminopeptidase for the diagnosis of ectopic pregnancy. Fertil Steril 39: 62–67

    PubMed  CAS  Google Scholar 

  • Breen JL (1970) A 21 year survey of 654 ectopic pregnancies. Am J Obstet Gynecol 106: 1004–1019

    PubMed  CAS  Google Scholar 

  • Brenner PF, Roy S, Mishell DR (1980) Ectopic pregnancy: a study of 300 consecutive surgically treated cases. J Am Med Assoc 243: 673–676

    Article  CAS  Google Scholar 

  • Brown TF, Filly RA, Laing FC (1978) Analysis of ultrasonographic criteria in the evaluation for ectopic pregnancy. Am J Roentgenol 131: 967–971

    CAS  Google Scholar 

  • Burford GD, Naftalin AA, Shaw RW (1986) The use of an enzyme linked immunosorbent assay for hCG in gynaecological emergencies. Br J Obstet Gynaecol 93: 87–89

    Article  PubMed  CAS  Google Scholar 

  • Chemitz J, Tornehorve D, Teisner B, Poulsen AR, Westergaard JG (1984) The localization of pregnancy proteins (hPL, SP1 and PAPP-A) in intra-and extrauterine pregnancies. Placenta 5: 489–494

    Article  Google Scholar 

  • Crawford E, Hutchinson H (1954) A decade of reports on tubal pregnancies condensed from the literature plus 300 consecutive cases without a death. Am J Obstet Gynecol 67: 567–584

    Google Scholar 

  • Draa CC, Baum HC (1951) Posterior colpotomy: an aid in the diagnosis and treatment of ectopic pregnancy. Am J Obstet Gynecol 61: 300–311

    PubMed  CAS  Google Scholar 

  • Flege JB (1966) Ruptured tubal pregnancy with elevated serum alpha amylase levels. Arch Surg (Chicago) 92: 379–398

    Article  Google Scholar 

  • Gleicher N, Giglia RV, Deppe G, Elrad H, Friberg J (1983) Direct diagnosis of unruptured ectopic pregnancy by real time ultrasonography. Obstet Gynecol 61: 425–428

    PubMed  CAS  Google Scholar 

  • Gordon PP (1980) Frozen section examination of endometrial curettings: an aid to the rapid diagnosis of ectopic pregnancy. Diag Gynecol Obstet 2: 77–83

    CAS  Google Scholar 

  • Grudzinskas JG, Westergaard JG, Teisner B (1986) Biochemical assessment of placental function: early pregnancy. Clin Obstet Gynecol 13: 553–569

    CAS  Google Scholar 

  • Gruneberger W, Leodolten S, Spona J (1977) The LH/hCG test, a valuable aid in the diagnosis of tubal pregnancy. Gynaecol Obstet Invest 3: 150–153

    Google Scholar 

  • Helvacioglu A, Long EM, Yang SL (1979) Ectopic pregnancy. An eight year review. J Reprod Med 22: 87–92

    Google Scholar 

  • Ho PC, Jones WR (1980) Pregnancy specific beta-1 glycoprotein as a prognostic indicator in complications of early pregnancy. Am J Obstet Gynecol 138: 253–256

    PubMed  CAS  Google Scholar 

  • Hochberg CJ (1974) Tubal alpha amylase. Obstet Gynecol 43: 129–131

    PubMed  CAS  Google Scholar 

  • Home CHW, Towler CM, Pugh-Humphries RGP, Thompson AW, Bohn H (1976) Pregnancy specific beta-1 glycoprotein: a product of the syncytiotrophoblast. Experientia 32: 1197–1199

    Article  Google Scholar 

  • Hubinont CJ, Thomas C, Schwers JF (1987) Luteal function in ectopic pregnancy. Am J Obstet Gynecol 156: 669–674

    PubMed  CAS  Google Scholar 

  • Jouppila P, Tapanainen J, Huhtaniemi I (1980a) Plasma hCG and ultrasound in suspected ectopic pregnancy. Eur J Obstet Gynecol Reprod Biol 10: 3–12

    Article  PubMed  CAS  Google Scholar 

  • Jouppilla P, Huhtaniemi I, Tapanainen J (1980b) Early pregnancy failure: study by ultrasonic and hormonal methods. Obstet Gynecol 55: 42–47

    Article  Google Scholar 

  • Kadar N, DeVore G, Romero R (1981) Discriminatory hCG zone: its use in the sonographic evaluation for ectopic pregnancy. Obstet Gynecol 58: 156–161

    PubMed  CAS  Google Scholar 

  • Kadar N, Taylor KW, Rosenfield A (1983) The sonographic appearance of the uterus in ectopic pregnancy. AJR 141: 609–615

    PubMed  CAS  Google Scholar 

  • Kitchin JD, Wein RN, Nunley WC, Thiagarajah S, Thornton WN (1979) Ectopic pregnancy: current clinical trends. Am J Obstet Gynecol 134: 870–876

    PubMed  Google Scholar 

  • Kjessler B, Johansson SGO, Lidbjork G, Sherman MS (1977) AFP levels in maternal serum in relation to pregnancy outcome in 7158 pregnant women prospectively investigated during their 14–20 week post last menstrual period. Acta Obstet Gynecol Scand Suppl 69: 25–44

    Article  PubMed  CAS  Google Scholar 

  • Landesman R, Saxena BB (1976) Results of the first 1000 radioreceptorassays for the determination of hCG: a new, rapid, reliable and sensitive pregnancy test. Fertil Steril 27: 357–368

    PubMed  CAS  Google Scholar 

  • Lenton EA, Neal LM, Sulaiman R (1982) Plasma concentrations of hCG from the time of implantation until the second week of pregnancy. Fertil Steril 37: 773–778

    PubMed  CAS  Google Scholar 

  • L’Hermite-Baleriaux AM, Van Exter C, Delville JL (1982) Alteration of free hCG subunit secretion in ectopic pregnancy. Acta Endocrinol 100: 109–113

    PubMed  Google Scholar 

  • McGeachin RL, Hargan LA, Potter BA, (1958) Alpha-amylase in fallopian tubes. Proc Soc Exp Biol Med, 99: 130–134

    PubMed  CAS  Google Scholar 

  • Matthews CP, Coulsen CB, Wild RA (1986) Serum progesterone levels as an aid in the diagnosis of ectopic pregnancy. Obstet Gynecol 68: 390–394

    PubMed  CAS  Google Scholar 

  • Milwidski A, Adoni A, Segal S, Palti Z (1977) Chorionic gonadotrophin and progesterone levels in ectopic pregnancy. Obstet Gynecol 50: 145–147

    Google Scholar 

  • Milwidski A, Adoni A, Miodovnik M, Segal S, Palti Z (1978) hCG (beta subunit) in the early diagnosis of ectopic pregnancy. Obstet Gynecol 51: 725–726

    Google Scholar 

  • Milwidski A, Segal S, Menashi M, et al. (1984) Corpus luteum function in ectopic pregnancy. Int J Fertil 29 (4): 244–246

    Google Scholar 

  • Norman RJ, Lowings C, Chard T (1985) Dipstick method for hCG suitable for emergency use on whole blood and other fluids. Lancet 1: 19–20

    Article  PubMed  CAS  Google Scholar 

  • Olsen CM, Holt JA, Alenghat E (1983) Limitations of qualitative serum beta-hCG assays in the diagnosis of ectopic pregnancy. J Reprod Med 28: 838–842

    Google Scholar 

  • Pedersen JF (1980) Ultrasonic scanning in suspected ectopic pregnancy. Br J Radiol 53: 1–4

    Article  PubMed  CAS  Google Scholar 

  • Piironen O, Punnonen R (1981) The use of ultrasonography in the diagnosis of ectopic pregnancy. Clin Radiol 32: 331–335

    Article  Google Scholar 

  • Poulsen HK, Westergaard JG, Teisner B, Bolton AE, Grudzinskas JG (1987) Undetectable circulating placental hormones and proteins in some women with ectopic gestation. J Obstet Gynaecol 7: 274–276

    Google Scholar 

  • Radwanska E, Frankenberg J, Allen EI (1978) Plasma progesterone levels in normal and abnormal early human pregnancy. Fertil Steril 30: 398–402

    PubMed  CAS  Google Scholar 

  • Riddle AF, Sharma V, Mason B, Ford N, Pampiglione J, Parsons J, Campbell S (1987) Two years experience of ultrasound directed oocyte retrieval. Fertil Steril 48: 454–458

    PubMed  CAS  Google Scholar 

  • Romero R, Kadar N, Jeanty P, et al (1985) The diagnosis of ectopic pregnancy: the value of the hCG discriminatory zone. Obstet Gynecol 66: 357–360

    PubMed  CAS  Google Scholar 

  • Saxena BB, Landesman R (1975) The use of radioreceptor assays of hCG for the diagnosis and management of ectopic pregnancy. Fertil Steril 26: 397–404

    PubMed  CAS  Google Scholar 

  • Schiffer MA (1963) A review of 2668 ectopic pregnancies. Am J Obstet Gynecol 86: 264–270

    PubMed  CAS  Google Scholar 

  • Schwartz RO, DiPietro DL (1980) Beta-hCG as a diagnostic aid for suspected ectopic pregnancy. Obstet Gynecol 56: 197–203

    PubMed  CAS  Google Scholar 

  • Seppälä M, Vaesmea P, Rutanen EM (1980) Pregnancy-specific beta-1 glycoprotein in ectopic pregnancy. Am J Obstet Gynecol 136: 189–193

    PubMed  Google Scholar 

  • Sinosich MJ, Smith DH, Grudzinskas JG, Saunders DM, Westergaard JG, Teisner B (1983) The prediction of early pregnancy failure by measurement of PAPP-A following IVF and ET. Fertil Steril 40: 539–541

    PubMed  CAS  Google Scholar 

  • Sinosich MJ, Ferrier A, Teisner B, et al. (1985) Circulating and tissue concentrations of PAPP-A in tubal ectopic gestation. Clin Reprod Fertil 3: 311–317

    PubMed  CAS  Google Scholar 

  • Soisson FL, Moran JP (1959) Ectopic pregnancy: a review of 50 cases at Tripler US Army Hospital. Am J Obstet Gynecol 77: 352–363

    PubMed  CAS  Google Scholar 

  • Stabile I, Riddle A, Campbell S, Grudzinskas JG (1987) The diagnosis of early pregnancy failure. In: Teo ES (ed) Advances in fertility and sterility, vol 1. Parthenon Publishing, Lancs, pp 153–160

    Google Scholar 

  • Stenman UH, Alfthan H, Myllynen L, Seppälä M (1983) Ultrarapid and highly sensitive time resolved fluoroimmunometric assay for chorionic gonadotrophin. Lancet 11: 647–649

    Article  Google Scholar 

  • Tornehave D, Chemnitz J, Westergaard JG, et al. (1986) Placental proteins in peripheral blood and tissue of ectopic pregnancies. Gynaecol Obstet Invest 23: 97–102

    Article  Google Scholar 

  • Webster HD, Barclay DL, Fischer CK (1965) Ectopic pregnancy: a seventeen year review. Am J Obstet Gynecol 92: 23–34

    PubMed  Google Scholar 

  • Weiner CP (1981) The pseudogestational sac in ectopic pregnancy. Am J Obstet Gynecol 139: 959–961

    PubMed  CAS  Google Scholar 

  • Westergaard JG (1987) MD Thesis, University of Odense, Denmark

    Google Scholar 

  • Yaffe H, Navot D, Laufer N (1979) Pitfalls in early detection of ectopic pregnancy. Lancet 1: 277

    Article  PubMed  CAS  Google Scholar 

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Authors
  1. I. Stabile
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  2. J. G. Westergaard
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  3. J. G. Grudzinskas
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Editor information

Editors and Affiliations

  1. Department of Obstetrics and Gynaecology, Guy’s Hospital, SE1 9RT, London, UK

    Michael G. Chapman MRCOG

  2. Academic Unit of Obstetrics and Gynaecology, The London Hospital, Whitechapel, E1 1BB, London, UK

    J. Gedis Grudzinskas MRCOG, FRACOG

  3. Academic Unit of Reproductive Physiology, St Bartholomew’s Hospital Medical College, EC1A 7BE, London, UK

    Tim Chard MD, FRCOG

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© 1988 Springer-Verlag Berlin Heidelberg

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Stabile, I., Westergaard, J.G., Grudzinskas, J.G. (1988). Ectopic Pregnancy: Diagnostic Aspects. In: Chapman, M.G., Grudzinskas, J.G., Chard, T. (eds) Implantation. Springer, London. https://doi.org/10.1007/978-1-4471-3529-6_17

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  • DOI: https://doi.org/10.1007/978-1-4471-3529-6_17

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-3531-9

  • Online ISBN: 978-1-4471-3529-6

  • eBook Packages: Springer Book Archive

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