A sensitive qualitative pregnancy test (ICON) and ultrasound in the diagnosis of ectopic pregnancy.
Three hundred and twenty-four patients presenting to Wellington Women's Hospital with symptoms suspicious of an ectopic pregnancy were first studied by testing serum for HCG using a new simple and sensitive (25 mIU/mL) ICON pregnancy test. One hundred and thirty ICON tests were positive. Subsequent management: (a) Immediate laparoscopy noted 3 intrauterine and 15 ectopic pregnancies. (b) Twenty-five patients discharged on revised clinical grounds without pregnancies. (c) An immediate ultrasound examination of 87 women showed 58 intrauterine pregnancies (including 1 misdiagnosed ectopic pregnancy) and 29 ectopic pregnancies which were later confirmed at laparoscopy. One hundred and ninety-four ICON tests were negative including two false negative results in patients with ectopic pregnancies. To avoid both unnecessary laparoscopy or the discharge of patients with a possible ectopic pregnancy, patients with symptoms and signs suspicious of an ectopic pregnancy and who present to hospital should have a rapid sensitive HCG assay. Then, if the test is positive (sensitivity 96%), an ultrasound examination can assist in determining the likely site of the pregnancy.
Weerasinghe
D S
DS
Department of Obstetrics and Gynaecology, Wellington School of Medicine.
Strand
L
L
Cooke
R
R
Flower
J
J
Hutton
J D
JD
D006063:Chorionic Gonadotropin / Q000097:blood; D005069:Evaluation Studies as Topic; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D010535:Laparoscopy; D009520:New Zealand; D011247:Pregnancy; D011259:Pregnancy Tests, Immunologic; D011271:Pregnancy, Ectopic / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D014463:Ultrasonography
D006063:Chorionic Gonadotropin