Value of culdocentesis in the diagnosis of ectopic pregnancy.
The diagnostic value of culdocentesis was examined in all patients admitted with hemoperitoneum during a three-year period. There was a total of 158 women with positive culdocentesis, of whom 132 (83.5%) had tubal ectopic pregnancies and 26 had other diagnoses. Of the 132 patients with ectopic gestations, the majority (62%) had unruptured tubes. A nondiagnostic culdocentesis should not be used either to raise or to lower the clinician's suspicion of ectopic pregnancy as 16% of patients with an ectopic pregnancy had a nondiagnostic culdocentesis, of which one-quarter were ruptured and three-quarters had hemoperitoneum diagnosed at the time of surgery. A positive culdocentesis along with a positive serum human chorionic assay was associated with an ectopic pregnancy in 99.2% of cases. This procedure should not be limited to the evaluation of patients with classic peritoneal signs, as 45% of the authors' patients with a positive culdocentesis did not have such findings.
D001707:Biopsy, Needle; D006063:Chorionic Gonadotropin / Q000097:blood; D003937:Diagnosis, Differential; D004312:Douglas' Pouch / Q000473:pathology; D004630:Emergencies; D005187:Fallopian Tubes / Q000473:pathology; D005260:Female; D006801:Humans; D011247:Pregnancy; D011258:Pregnancy Tests / Q000379:methods*; D011271:Pregnancy, Ectopic / Q000175:diagnosis*; D011274:Pregnancy, Tubal / Q000175:diagnosis; D012189:Retrospective Studies
D006063:Chorionic Gonadotropin