[Diagnosis of ectopic pregnancy]

The knowledge of ectopic pregnancies risk factors (intra-uterine device; past history of pelvic inflammatory disease; history of tubal pathology and tubal surgery; positive chlamydiae serology; and smoking), the high sensitivity and specificity of radioimmunological assay of beta-HCG and the availability of high resolution sonography using vaginal probes had improved the routinely diagnosis of ectopic pregnancy. Today, diagnosis was made with beta-HCG and vaginal echography. Uterine vacuity, peritoneal liquid and latero-uterine masse represent the major ultrasound signs. However, diagnosis can be uncertain below discriminative zone of beta-HCG (< 1,500 to 2,000 UI/L). Other new diagnostic markers are also described, as progesterone, creatine kinase, VEGF and CA 125. The place of ponction of the Douglas, endouterine curettage, hysteroscopy and laparoscopy are also defined for diagnosis of ectopic pregnancy.