Ectopic Pregnancy Diagnosis Without Uterine Curettage Is Often Incorrect

Successful medical management of ectopic pregnancy necessitates early diagnosis without laparoscopy; these nonsurgical diagnoses are made by sensitive β-human chorionic gonadotropin (hCG) assays and high-resolution ultrasound. In this retrospective cohort analysis, the accuracy of nonsurgical diagnosis of ectopic pregnancy was evaluated among 112 clinically stable pregnant women at risk for ectopic pregnancy who underwent diagnostic dilation and curettage (D&C) before treatment.

Women were considered at risk for ectopic pregnancy if they had no visible intrauterine pregnancy (IUP) on ultrasound despite a serum hCG concentration ≥2000 mIU/mL (the concentration at which ultrasound can reliably diagnose IUP), or if they had sequential serum hCG…