How is early pregnancy loss differentiated from an ectopic pregnancy?

Updated: Nov 05, 2018
  • Author: Slava V Gaufberg, MD; Chief Editor: Jeter (Jay) Pritchard Taylor, III, MD  more...
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Answer

Perform pregnancy testing for every woman of childbearing age who presents with lower abdominal pain, vaginal bleeding, or both. History alone is not sufficient to exclude pregnancy. Pregnancy is possible even if the patient gives a history of a recent normal menstrual period, lactation, or contraceptive use.

Rule out ectopic pregnancy. An ectopic pregnancy must be excluded in every pregnant woman with abdominal pain, vaginal bleeding, or both during the first or second trimester. Endometrial shedding, which clinically simulates miscarriage, may occur with an ectopic pregnancy. This misdiagnosis is the greatest potential pitfall. An empty uterus on sonogram may represent an ectopic pregnancy.


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