“Rule Out Ectopic”: Can Any Single Test Clinch the Diagnosis?

Early detection of ectopic pregnancy lowers morbidity and mortality associated with tubal rupture or spontaneous abortion; however, current diagnostic tools fail to achieve a single-visit diagnosis in as many as 40% of women with ectopic gestations. Investigators reviewed 14 studies to evaluate clinical tools for assessing hemodynamically stable women with suspected ectopic pregnancy.

Ectopic pregnancy was diagnosed in 15% of pregnant women who presented with pelvic pain or vaginal bleeding. Patient history was not diagnostically useful (positive likelihood ratio [+LR] <1.5). Cervical motion tenderness and abdominal tenderness on physical exam were associated with moderately elevated risk for ectopic gestation (+LR, 4–5). Importantly, normal…