[Diagnosis of ectopic pregnancy: endometrial biopsy or diagnostic hysteroscopy]

Define indications for endometrial biopsy and diagnostic hysteroscopy in ectopic pregnancy diagnosis. Define the indication of endometrial biopsy and diagnostic hysteroscopy in ectopic pregnancy diagnosis.

This prospective study included 15 women with a poorly localized pregnancy (ectopic or intrauterine localization not identified at ultrasound) who had an abnormal HCG curve and low progesteronemia.

In 8 patients, an empty cavity was identified at diagnostic hysteroscopy and the endometrial biopsy was negative. In 2 patients hysteroscopy was non-contributive (pregnancy and intra uterine device with blood in the cavity) and the endometrial biopsy was negative. In 3 patients who had an early abortion hysteroscopy and endometrial biopsy demonstrated villosities. Finally, in 2 patients who had an early abortion hysteroscopy identified villosities and endometrial biopsy was non-contributive. The sensitivity and specificity of hysteroscopy for the diagnosis of EP was 100% but the sensitivity of endometrial biopsy was 50% with a specificity of 100%.

If pregnancy cannot be correctly localized at ultrasonography, hysteroscopy appears to be better than endometrioal biopsy to discriminate between EP and early abortion.