Ectopic pregnancy: Forget the “classic presentation” if you want to catch it sooner

A decision model comparing 6 possible diagnostic strategies that combined clinical examination, TVUS, β-hCG, serum progesterone, and D&C showed that TVUS followed by serial serum β-hCGs in those with initial nondiagnostic ultrasound scans was the most accurate and efficient model.⁴⁰ By using this strategy, all ectopic pregnancies would be detected, fewer than 1 in 100 normal pregnancies would be interrupted, and diagnostic lag would average only 1.46 days.

CORRESPONDENCE
K. Ramakrishnan, MD, Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, 900 NE 10th Street, Oklahoma City, OK 73104. E-mail: kramakrishnan@ouhsc.edu