Ectopic Pregnancy Diagnosis

Can an ectopic pregnancy be detected on a home pregnancy test

If you have an ectopic pregnancy, a home pregnancy test will give a positive result as it can still detect the hCG hormone in your urine ^[1]. Similarly, it is possible to get a negative pregnancy test in the early stages due to the hCG levels being too low ^[2].

How soon can an ectopic pregnancy be detected

An ectopic pregnancy is usually suspected between the fifth and tenth weeks of pregnancy, often a couple of weeks after the missed period ^[3].

How is an ectopic pregnancy diagnosed

It might be pretty difficult to diagnose an ectopic pregnancy, as the gestational sac may sometimes get implanted in odd places where it may be difficult to detect it on a regular ultrasound scan. The initial diagnosis is done based on your medical history and your symptoms. The doctor may also do a pelvic exam to check for any tender mass in the lower abdomen ^[4]. One or more of the following procedures may be used for confirming the diagnosis.

Blood test for measuring hCG levels

A blood test may be performed to measure the hCG hormone levels if an ultrasound fails to show a developing fetus in the uterus even after you enter the 6th week of pregnancy ^[2]. You are suspected to have an ectopic pregnancy if your hCG levels range between 1500 to 2000 mIU/mL with no visible fetus ^[5].

In a healthy pregnancy, the hCG levels double up every 2 to 3 days until it peaks sometime between the 8th and 11th weeks ^[6]. So your doctor may repeat the test a few times to monitor the hormone level as it is usually lower in an ectopic pregnancy ^[7].

Transvaginal Ultrasound

Although an ultrasound cannot be conclusive for confirming an ectopic pregnancy, it can help to look for the gestational sac, inside or outside the uterus. An ultrasound can usually detect a normal pregnancy after the 5th or 6th week ^[8]. It may also show an empty uterus along with an unusual mass within the fallopian tube or in some other abnormal location, suggesting an ectopic ^[4].

Ectopic Pregnancy Ultrasound Picture — Ectopic Pregnancy Ultrasound

However, if your doctor fails to see anything on the ultrasound, it does not rule out an extra-uterine pregnancy as up to 15%-26% women with an ectopic pregnancy have negative ultrasound results. At the same time, seeing an empty uterus cannot rule out a normal pregnancy, especially before the 7th–8th week ^[5].

Laparoscopy

In some rare cases, a laparoscopy may be necessary to confirm an ectopic pregnancy. It involves inserting a thin instrument with a tiny camera through a small incision in your abdomen to detect the exact site of the ectopic pregnancy ^[7].

Differential diagnosis

The differential diagnosis usually includes a miscarriage, acute appendicitis and pelvic inflammatory disease ^[9].

Complications: Ruptured ectopic pregnancy

Unless diagnosed and treated at an early stage, an ectopic pregnancy could lead to rupture of the fallopian tube (or any other organ it is attached to), causing severe internal bleeding ^[10]. It can even result in shock as the blood pressure may suddenly drop to an extremely low level ^[11]. Without prompt treatment, it can even turn fatal with the risk of death being higher the later the complication is detected ^[12].

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