What tests will a doctor conduct if he suspects the pregnancy to be ectopic?

Answer 1

The first step a doctor will do if he suspects ectopic pregnancy is a thorough pelvic examination to identify pain, tenderness or lump in fallopian tube or ovary. However, this does not give a clear idea on if the pregnancy has happened within the tubes. If the doctor identifies any abnormalities, following further tests are carried out:

1. Ultrasound pelvic scan - This method uses sound waves to determine if the fetus is implanted in the uterus or in the fallopian tubes. A transvaginal probe (instrument resembling stick) is inserted into the vagina and scan is done. This does not require anesthesia.

2. Blood examination to check the levels of hCG - hCG stands for Human Chorionic Hormone; the levels of these are always used to detect pregnancy. During normal pregnancy there is an increase in the levels of hCG and Progesterone. If the pregnancy is ectopic, the levels are lower compared to the normal levels and thus, this can be taken as the parameter for diagnosis.

3. Laparoscopy - If the presence of ectopic pregnancy is still unclear, the doctor opts to perform a laparoscopy, which is a minimal incision surgical procedure done under general anesthesia. A small nick is made in the abdominal area through which a tube is inserted to view the presence of fetus in tube. If it is present the doctor would prefer to break the fetus down into smaller parts leading to complete removal of the extracts through vaginal opening.

Answer 2

In a regular pregnancy, the fertilized egg goes through the fallopian tube and then attaches itself to the uterus. However, in rare cases, the egg traveling up fallopian tube tends to attach itself to something other than the uterus. It could be fallopian tube - in most cases. This is also the reason that ectopic pregnancy is often referred to as tubal pregnancy. In some cases it may attach to the ovary or belly too. Here are examinations and tests done by the doctor if he/ she doubts the same-

1. Manual pelvic exam

Pelvic exam is done for reviewing the tenderness of the uterus or even the fallopian tubes. If the uterus is not enlarged properly or there seems to be a mass in the pelvic region, there is a chance that the pregnancy is ectopic.

2. Pelvic Ultrasound

Ultrasound of the pelvic area is a common and also more accurate mean of determining the nature of the pregnancy. A pelvic ultrasound can either be transvaginal or abdominal. In both cases the sound waves are used for getting picture of the internal organs. Often, doctors rely on transvaginal ultrasound. Usually the uterus pregnancy is visible 6 weeks post the last menstrual period. But in case of an ectopic pregnancy, there would be no signs of embryo implantation.

3. Blood tests

Blood tests are also taken during this period to check the hormonal levels. The pregnancy hormone (human chorionic gonadotropin or hCG) tends to grow every 2 days or rather doubles. But if the pace of this hCG is lesser than double or every low, it could mean that a case of ectopic pregnancy or a miscarriage exists.

4. Laproscopy - doubles as a test cum treatment

Laparoscopy is another commonly used method to detect ectopic pregnancy. It usually occurs 5 weeks post the pregnancy has been diagnosed. But this is not a very accurate method for the same. Laparoscopy is preferred as a treatment method rather than testing method these days.