Ectopic Pregnancy - Diagnosis

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Ectopic Pregnancy - Diagnosis
Ectopic Pregnancy - Diagnosis
Video: Ectopic Pregnancy - Diagnosis
Video: Ectopic Pregnancy - Overview (pathophysiology, signs and symptoms, treatment, investigations) 2023, February

Ectopic pregnancy: diagnosis

An ectopic pregnancy is often diagnosed by a gynecologist between the sixth and ninth weeks of pregnancy. At this point the embryo in the fallopian tube has reached a size that leads to characteristic symptoms. Sometimes the diagnosis is made by chance at an earlier point in time without any symptoms being present.

If an ectopic pregnancy is not recognized in time, dangerous complications can result.


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At the beginning, an ectopic pregnancy usually does not cause any symptoms, or the woman may notice classic signs of pregnancy and assume a "normal" pregnancy. Only when the embryo reaches a size that leads to wall tension in the fallopian tube do characteristic signs such as unilateral, pulling pelvic pain or vaginal bleeding appear.

More on the topic: Ectopic pregnancy: what is it?

How is the diagnosis made?

There are several steps that must be taken to make a reliable diagnosis of an ectopic pregnancy.


If there are symptoms that indicate an ectopic pregnancy, the gynecologist will first find out about possible previous illnesses and risk factors (e.g. previous surgical interventions, infections, previous malfunctions, endometriosis, etc.).

Gynecological check

During a pelvic exam, the following signs may indicate an ectopic pregnancy:

  • Unilateral sensitivity to pain: The affected fallopian tube in which the egg has lodged is very sensitive to pain.
  • Sensitivity to pain in the cervix: When the cervix is lifted or moved, pain occurs which is typical of an ectopic pregnancy.
  • The cervix is ​​closed and there is often light spotting.

Pregnancy test & laboratory examination

Since the placenta also produces the pregnancy hormone beta-hCG in an ectopic pregnancy, a pregnancy test will be positive. A normal pregnancy cannot be distinguished from an ectopic pregnancy. More on the topic: Pregnancy: Diagnosis

Long-term observation of the ß-hCG level in the blood is more informative: In a normal, intact pregnancy, the ß-hCG level in the blood rises steadily in the first weeks of pregnancy (it doubles every 48 hours). In an ectopic pregnancy, the embryo cannot develop in the same way as in a normal pregnancy; it often dies after a few weeks. In this case, the ß-hCG level rises only slowly, remains unchanged or falls again. Repeated measurements of the ß-hCG in the blood can therefore indicate whether the pregnancy is intact or not.

Note With the aid of this follow-up check, an intact pregnancy can be recognized or ruled out, but it does not provide any information about the location at which the implantation took place. An ultrasound examination is also necessary for this.


An ultrasound scan can help determine whether or not there is a pregnancy in the uterus. In early pregnancy, the examination is carried out through the vagina (vaginal ultrasound). If the pregnancy test is positive or if the ß-hCG values ​​are elevated, but no pregnancy is evident in the uterus, an ectopic pregnancy (or another form of ectopic pregnancy) must be considered.

The ovaries and fallopian tubes are also assessed using an ultrasound scan. Fluid in the abdomen can also be detected by means of ultrasound, if necessary; this can be another indication of a bleeding ectopic pregnancy.

Note Identifying an ectopic pregnancy is often difficult at a very early stage. If necessary, a so-called color Doppler ultrasound can be used; This allows structures with a good blood supply (such as the egg cell nested in the mucous membrane) to be detected, even if they are very small.

The diagnosis can usually be confirmed through the combination of symptoms, ultrasound examination and ß-hCH value. In unclear cases, a laparoscopy may also be necessary.

Whom can I ask?

A visit to a gynecologist is necessary to clarify an ectopic pregnancy. In acute cases (e.g. severe pelvic pain) you can also contact a hospital outpatient department for gynecology or, in medical emergencies, the ambulance at 144.

How are the costs going to be covered?

The e-card is your personal key to the benefits of the statutory health insurance. All necessary and appropriate diagnostic and therapeutic measures are taken over by your responsible social insurance agency. A deductible or contribution to costs may apply for certain services. You can obtain detailed information from your social security agency. Further information can also be found at:

  • Right to treatment
  • Visit to the doctor: costs and deductibles
  • What does the hospital stay cost?
  • Prescription fee: This is how drug costs are covered
  • Health Professions AZ

and via the online guide to reimbursement of social insurance costs.

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