Diagnosis of intrauterine and ectopic pregnancy at 5-7 postmenstrual weeks

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Abstract
The potential of the combined use of vaginosonography and serum beta-hCG levels for early diagnosis of intrauterine and ectopic pregnancies (5-7 weeks postmenstrual) was investigated in a multicentric study. Three hundred and forty-nine patients underwent vaginosonographic examination and determination of serum beta-hCG. When the first examination failed in establishing a precise diagnosis, repeat examinations were performed on alternate days. During the first 3 weeks after the missed menses, vaginosonography can detect practically all viable intrauterine pregnancies, half of the nonviable intrauterine and viable ectopic pregnancies, and one quarter of nonviable ectopic pregnancies, respectively. It was not possible to differentiate intrauterine and ectopic pregnancies by serum beta-hCG levels. Vaginosonographic screening, ideally at 2 weeks after the missed menses, permits detection, localization, and dating in 80%-90% of suspected pregnancies.