Ectopic pregnancy; early diagnosis, clinical errors and conservative operation

This report of eight years' experience with extrauterine pregnancy by a single gynecologist is an exposition of how the diagnosis was made or why it was missed. Of 26 diagnoses of ectopic pregnancy, five were false (20 per cent); and in three cases (10 per cent) the diagnosis was not made promptly-a total error of 30 per cent. Ectopic pregnancy will be discovered earlier if obstetric patients are always examined shortly after missing the first menstrual period.A palpable adnexal mass was present in 19 of 21 ectopic pregnancies (90 per cent). A mass was palpable in only one of five cases erroneously diagnosed as ectopic pregnancy (20 per cent).Decidual casts were passed by four patients, two of whom did not have ectopic pregnancy. If two gynecologists do not agree on the question of extrauterine pregnancy, a third opinion should be sought or culdoscopy employed. Enucleation of the conceptus and salvage of the oviduct is advocated.