In our office we joke about the accuracy of rain prediction: I usually say it is correct about 50% of the time, what's your take? In medicine we have improved the diagnosis of tubal pregnancy greatly, but unfortunately the initial diagnosis of ectopic pregnancy may be incorrect up to 40 percent of the time! In a new study that looked at the medical consequences of missing this diagnosis they discuss that the medications used to treat tubal pregnancy, in the cases that can be treated with medicine, can be harmful to a pregnancy that is actually developing in the uterus and may go on to term. They also have cautioned that several tests over a period of days are needed to confirm the diagnosis of a tubal (ectopic) pregnancy, and that women need to understand that patience is often important. Pregnancies develop at a different pace in different women and the levels of hormone and when and how rapidly the different structures are visualized on ultrasound can also vary.In a study reported by Dr. Andrew Kaunitz in the February 2012 issue of OBG Management he said that you should be able to see a pregnancy in the uterus about the serum beta-HCG level is in the 1000-2000 rante. And that if you see no pregnancy one day, and look with the ultrasound to try to see a pregnancy...the VERY NEXT DAY... about 80% of the time it was because that level was below the 1000 mIU/ml value for that pregnancy HCG blood test, but about 10% of the time the value was 1500 or even higher! So we have to interpret these values very carefully, and the value and the ultrasound almost have to be interpreted in isolation, not an 'either or'.
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