抄録
Objective: Recently, the diagnosis of the ectopic pregnancy [EP] have advanced by serum human chorionic gonadotoropin [hCG] levels and a high-resolutional transvaginal ultrasonography. Therefore, the recent strategies for EP make it possible to diagnose EP in the early stage and it seems that the operation of the asymptomatic cases increase. However there are some cases that are hard to discriminate EP and intrauterine pregnancy [IUP], especially in their early stage. We report about five cases which turned out that they were not EP after laparoscopic surgery.
Design: Retrospective analysis.
Methods: We identified 5 cases with misdiagnosis as EP between April, 2005 and March, 2008. And we assessed for the data on patient characteristics, clinical presentations , and surgical findings.
Results: Misdiagnosis rate was 4.1% (5/121). All cases had regular menstrual cycles and were spontaneous pregnancies. 4 cases were introducted for EP doubt, one had lower abdominal pain. In three cases, serum β-hCG were above 1500mIU/ml (1643-2892mIU/ml). Transvaginal ultrasonography findings showed GS like echo near the adnexal lesion in 3 cases, one had hematoma in the adnexal lesion, another had ascites image in douglas pouch that seemed bleeding in the peritoneal cavity. All 5 cases were finally diagnosed spontaneous abortion and GS like echo appeared corpus luteum in 2 cases, ascites image appeared ovarian bleeding in one case.
Conclusions: All of misdiagnosed 5 cases were intrauterine nonviable pregnancy. In order to avoid misdiagnosis, it is important to evaluate their general status closely and dilatation and curettage as gradual strategy is previously performed when the diagnosis is suspicious.
