Letters

Diagnosing suspected ectopic pregnancyCan we offer completely non-surgical management for ectopic pregnancy?Patients with falling concentrations of human chorionic gonadotrophin should be seen regularly

BMJ 2001; 322 doi: https://doi.org/10.1136/bmj.322.7289.793 (Published 31 March 2001) Cite this as: BMJ 2001;322:793

Can we offer completely non-surgical management for ectopic pregnancy?

  1. Ashis K Sau, specialist registrar in obstetrics and gynaecology (ashis@sau3.freeserve.co.uk),
  2. Mita Sau, specialist registrar in obstetrics and gynaecology
  1. Department of Obstetrics and Gynaecology, Kent and Canterbury Hospital, Canterbury CT1 3NG
  2. Department of Obstetric and Gynaecology, Farnborough Hospital, Orpington, Kent BR6 8ND
  3. Watford General Hospital, Watford WD1 8HB

    EDITOR—In his editorial Ankum discussed using measurements of serum concentrations of human chorionic gonadotrophin and transvaginal scanning to diagnose ectopic pregnancy.1 These two diagnostic modalities have opened up the possibility of a new era of non-laparoscopic diagnosis. Owing to the inconsistencies in the calibration of assays for human chorionic gonadotrophin and variations in the ability of ultrasonographers, each department should define its own “discriminatory zone” for human chorionic gonadotrophin.2 Clinicians using non-laparoscopic diagnostic algorithms should be prepared to perform a laparoscopy when the concentration of human chorionic gonadotrophin is <2000 mIU/ml and there is less than a 50% increase in human chorionic gonadotrophin in 48 hours with no intrauterine gestation sac on transvaginal scanning.3

    Laparoscopy should be used for treatment more often than for the diagnosis of ectopic pregnancy. Are we in a position to offer that? …

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