ABSTRACT
The most common presenting symptoms of ectopic pregnancy are lower abdominal pain (90 percent), vaginal bleeding (80 percent), and amenorrhea (70 percent). Sometimes in pregnant patients with demonstrable circulating Human chorionic gonadotropin, the uterus is presumably empty, but ectopic pregnancy does not occur. These results always require careful interpretation in patents with irregular cycles, those who stopped usage of oral contraceptive therapy, or in those with blighted ova. A real diagnostic improvement of ectopic pregnancy is the direct recognition of the ectopic gestational sac with demonstrable fetal heart movements. A transvaginal ultrasound probe may provide superior visualization of the pelvic anatomy and improve the diagnosis of ectopic pregnancy. The clinical conclusion should not be based only on ultrasound, because one false negative diagnosis in ectopic pregnancy may result in a tragic and dramatic event. An empty uterus with positive biochemistry, but in the absence of an adnexal mass or free fluid, is only suggestive of an ectopic pregnancy.
