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July 16, 1982

Diagnosis of Ectopic Pregnancy

JAMA. 1982;248(3):310. doi:10.1001/jama.1982.03330030024015

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To the Editor.—  The outline for the detection of ectopic pregnancy by Dr Morton Stenchever (1982;247:1190) was thorough. I especially agree with his mandate to attempt limitation of the surgery and anesthesia attendant to laparoscopy. Culdocentesis is a rewarding procedure, but the results are only positive with ectopic rupture or leakage.That is why the use of ultrasonography, a noninvasive technique, in the differential diagnosis of ectopic pregnancy should be emphasized strongly. The finding of an intact intrauterine gestational sac is possible by four weeks and yields the diagnosis in all but the unlikely instance of a combined pregnancy. In more advanced ectopic pregnancies, fetal cardiac pulsations in an adnexal mass will verify the diagnosis.