The diagnosis and treatment of ectopic pregnancy has changed in the last century. "In the beginning of the 20th century, ectopic pregnancy was almost completely a fatal diagnosis. At the end of the century, we were so in tune with early diagnosis we were preserving a woman's fertility," he says, explaining that now a major concern is not just saving the woman but also preserving her ability to have children in the future. "It is really remarkable the change that has occurred in a tubal pregnancy."
With medical advances, such as transvaginal ultrasound (using a smaller probe inserted directly into the vagina) and sensitive hormone assays, doctors can zero in on this type of pregnancy as much as one week earlier than previously. To help determine the health of pregnancy, the pregnancy hormone human chorionic gonadotropin (hCG) is measured. This is the hormone that is only secreted during pregnancy or, rarely, in a tumor.
"If a patient is without symptoms we can use the actual level of the hormone as a 'discriminatory zone' to indicate an ectopic pregnancy. What that means is that when it is above a certain level, if we don't see a pregnancy inside the uterus, it is an ectopic pregnancy until proven otherwise," Dr. Trolice explains.