Ectopic Pregnancy: Diagnostic Dilemma and Delay

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Abstract
A retrospective analysis of 111 consecutive ectopic pregnancies was done regarding diagnostic difficulties and delay. Absence of amenorrhea before onset of symptoms was frequent (44.1%), as was a negative two‐minute slide pregnancy test (50.0%). The main factors causing diagnostic delay were the use of therapeutic drug trials and misdiagnosis at curettage. Diagnostic delay can be reduced by early use of more sensitive pregnancy tests in patients predisposed to ectopic pregnancy, more critical use of drug trial therapy in patients with gynecologic diagnostic problems, early resort to laparoscopy and rapid pathologic examination of tissue obtained from curettage done in suspected cases of spontaneous abortion or menorrhagia to detect decidual changes or Arias‐Stella phenomenon.

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