Ectopic pregnancy. A prospective study on differential diagnosis.

This study analyzes the clinicopathologic findings in patients with ectopic pregnancy (EP), and deals with the differential diagnosis of the EP, intrauterine pregnancy (IUP), and pelvic inflammatory disease (PID). We evaluated 346 patients with suspected EP. Among those, 119 patients had EP, 82 had IUP, and 55 had PID without pregnancy. The incidence of EP was 1/32.9 live births. Comparing with the other groups, the patients with EP were slightly older, gave a history of previous pregnancies, had acute abdominal pain, nausea, vomiting, dizziness, and fainting, and had direct and rebound abdominal tenderness, pain on motion of the cervix, absence of a pelvic mass, and bilateral adnexal or cul de sac fullness. Culdocentesis was accurate in 95.1% of EP cases. Salpingectomy was performed in 89.9% of the patients with EP. The patients with EP had gross evidence of PID at the surgery in 31% and microscopic evidence of tubal inflammation in 19.4% of cases.