Diagnosis of Ectopic Pregnancy

Your doctor will first perform a physical examination of the pelvic area to check for any pain or tenderness and the presence of any mass in the fallopian tube or ovary. By itself, a physical examination is insufficient to make a diagnosis of ectopic pregnancy. Your doctor may perform certain tests for ectopic pregnancy that will confirm the diagnosis. Typically, these tests include blood tests and imaging tests such as ultrasound.

  • Blood Tests: Early pregnancies may not be detectable by ultrasound. In such cases, your condition will be monitored with blood tests until the ectopic pregnancy can be confirmed at a later date by ultrasound. This is usually done at least four to five weeks after conception.

Specific tests to detect beta HCG levels in blood are also used to diagnose an ectopic pregnancy. These levels normally rise during pregnancy but during an ectopic pregnancy the rise is abnormal. They can provide clues that can help the doctor make a diagnosis of ectopic pregnancy.

  • Ultrasound: During standard ultrasound tests, you will be asked to drink a lot of water before the test is performed. This is because a full bladder makes the ultrasound image clearer. A probe is passed over your abdomen and high frequency ultrasonic waves are directed at your abdomen and the image recorded.

During early pregnancy, the uterus and fallopian tubes are closer to the vagina than the surface of the abdomen. In such cases, a trans-vaginal ultrasound test may be performed. An ultrasound probe will be inserted into the vagina and the images recorded on a monitor. Images taken during the test can reveal the position of the gestational sac and confirm if it is normal (intrauterine) or an ectopic pregnancy, but sometimes the results are inconclusive.

  • Laparoscopy: In rare instances when an ultrasound scan cannot confirm the presence of an ectopic pregnancy, a laparoscopy may be required to confirm the diagnosis. The procedure involves the insertion of viewing instruments through small incisions made in the abdominal wall. The doctor can then examine the insides of the pelvis and abdominal area to determine the site of the ectopic pregnancy.
  • Surgery: This is performed in emergency situations as in the case of heavy bleeding. The ectopic pregnancy will be diagnosed and treated surgically.