Stereomicroscopic demonstration of chorionic villi: differentiation between miscarriage and ectopic pregnancy

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Abstract
To evaluate direct peroperative stereomicroscopic examination of endometrial curettings in the differentiation between miscarriage and ectopic pregnancy. A prospective consecutive controlled study. Odense University Hospital, Odense, Denmark. One hundred and fifty-nine women with vaginal bleeding and/or abdominal pain in early pregnancy and no fetus seen on ultrasound. The results of stereomicroscopy were compared with the histological diagnoses. There was 90% (95% CI, 84-94%) agreement between the stereomicroscopic and histological examinations. Fifteen per cent had an ectopic pregnancy. The sensitivity of stereomicroscopy as a marker of ectopic pregnancy was 92% (73-99%), the specificity 94% (88-97%). The predictive value of a positive test was 73% (54-88%) and that of a negative test 98% (94-100%). Direct peroperative stereomicroscopy of endometrial curettings is a valuable diagnostic tool for immediate differentiation between miscarriage and ectopic pregnancy.