Diagnosing an ectopic pregnancy
Sometimes ectopic pregnancies have no symptoms. This means an ectopic pregnancy can be difficult to diagnose.
It can take more than one visit to a maternity hospital to make a diagnosis. Sometimes when you first visit the hospital it's not possible for your obstetrician or midwife to see exactly where the pregnancy is. This is called a 'pregnancy of unknown location'.
At the hospital a doctor or midwife will ask you questions about your symptoms. They'll want to know the date of your last period. Your doctor will also examine your tummy by pressing on it.
Your doctor may need to do a vaginal (internal) exam. They will ask you for your consent to do this. You can bring a person with you to the examination.
You might undergo the following tests to help diagnose an ectopic pregnancy:
- urine test
- blood test
- ultrasound scan
- laparoscopy (keyhole surgery)
The doctor will do a urine pregnancy test. You can bring a sample with you. The doctor may also test your urine for signs of infection or bleeding.
Some blood tests may be done to check your level of the pregnancy hormone hCG (human chorionic gonadotrophin). Sometimes you might need to return after a few days to have this level measured again, as a change in the level of this hormone may help to diagnose what is wrong.
Blood tests may also be done to check the level of another hormone called progesterone.
Most women who are suspected of having an ectopic pregnancy will be offered a transvaginal scan.
During this scan the doctor, ultrasonographer or midwife gently places an ultrasound probe into your vagina. This scan gives a clearer image of your womb.
Laparoscopy (keyhole surgery)
If the diagnosis remains unclear you may need an operation called a laparoscopy, also known as 'keyhole surgery'. It usually takes place under a general anaesthetic - this means you are asleep during the surgery.
During keyhole surgery, the surgeon makes a small cut on your tummy. A small camera passes through the hole. This camera can see your womb, fallopian tubes, and ovaries. The surgical team can examine the area in detail.
The surgeon can treat an ectopic pregnancy during the operation. In most cases, the doctor will discuss these steps with you before you go for the operation. If it is an emergency situation there may not be time to discuss these steps.