Ectopic pregnancy. 'Thinking ectopic,' key to diagnosis.

During the past decade, the number of ectopic pregnancies in the United States nearly tripled. Although maternal mortality from this cause declined over the same period, the rate could be further reduced with earlier diagnosis and treatment. After a pregnancy has been confirmed by urine or blood testing, its location, if questionable, should be determined by sonography. The possibility of ectopic pregnancy should be considered not only for patients at high risk but also for those whose signs and symptoms differ from textbook descriptions of ectopic pregnancy. Definitive treatment is surgical, with the choice of technique determined in part by the patient's feelings about future fertility.