The value of curettage in the diagnosis of ectopic pregnancy

The charts of all patients hospitalized between 1978 and 1983 with proved ectopic pregnancies at Northwestern Memorial Hospital, Chicago, and Meir Hospital, Kfar-Sava, Israel, were reviewed. Eighty-four patients with ectopic pregnancies had endometrial tissue available for histologic analyses. Review of the endometrial curettings revealed that the most common endometrium associated with ectopic pregnancy was secretory (39.4%). Proliferative endometrium present 19% of the time was as common a finding as Arias-Stella phenomenon. This study shows that any type of endometrium lacking trophoblasts may be associated with an ectopic pregnancy. The lack of decidual reaction or Arias-Stella phenomenon should not alone lower the clinician's index of suspicion.