The Gynaecologist's Perspective
Ectopic pregnancy still remains a condition which can be fatal. It can be an easy or extremely difficult diagnosis to make and the consequences of misdiagnosis can be dire. Although there are a number of investigations which can be performed, there is no agreed protocol and cut off points for serum HCG. Ectopic pregnancies are missed because the diagnosis has either not been considered, or considered but rejected. Also, there is debate about surgery and although it is RCOG recommendations that 80% of ectopic pregnancies are managed laparoscopically, due to the training and teaching of junior staff there is limited availability.
As a generalist gynaecologist, I believe it is important to raise the awareness of the condition and to advise on Chlamydia screening and treatment to reduce risks. The challenge in the future will be both in making the diagnosis and in also having appropriately trained surgeons to undertake minimal assess treatment.
Laurie Montgomery Irvine