Tests for confirmation of Ectopic Pregnancy - Dr. Sangeeta Gomes скачать в хорошем качестве

Tests for confirmation of Ectopic Pregnancy - Dr. Sangeeta Gomes

The moment the woman misses her periods she should do a urine pregnancy test. If it is positive then the next step is to do the serum beta hCG. Ideally the beta hCG doubles every 48 hours like if it is 200 today after 48 hours it should be 400 and after it reaches 1500 to 2000 the ultrasound will show a gestational sac in the uterus. If the beta hCG is not rising as per 48 hours rule or if it is rising only upto 50 to 60% and once the beta hCG rises to 1500 to 2000 and you do not see a gestational sac in the uterus, then there comes doubt of ectopic pregnancy. So you need to do a scan to check whether there is any adnexal mass , that is any mass surrounding the tubes, which could be a tubal pregnancy. Sometimes there could be a ring gestational sac and sometimes we can also see a small fetus with cardiac activity in it. Clinical history is also important. A woman has missed her period and her beta hCG is not rising properly and there is no gestational sac inside the uterus, she gives a history of pain abdomen, sudden nausea, vomiting and sudden fainting attacks. This could be a sign of some haemorrhage happening in the abdomen due to the rupture of the ectopic pregnancy or the tubal pregnancy. Sometimes we see the beta hCG rises from 1500 to 2000. There is no gestational sac in the uterus. Careful follow up with serial scanning and beta hCG has to be done. Some cases the beta hCG drops naturally and in some cases whether the pregnancy is inside the uterus or inside the tubes disappears naturally and hence careful follow up is very important. The patient should be given advise of some emergency signs and symptoms where she should approach the hospital immediately, like sudden fainting attacks, severe pain in the abdomen, nausea, vomiting.