The very early ectopic pregnancy - New possibilities of laparoscopic diagnosis using the Fridrich diaphanoscope

Purpose: Early diagnosis and treatment of tubal pregnancy increases the likelihood of avoiding rupture and preserving the tube. However, very early tubal pregnancies can escape detection, even at laparoscopy. A newly developed illuminated rod may improve the ability to detect very small tubal pregnancies. Methods: The illuminated rod was used during laparoscopy in a pilot series of 24 patients with vaginal bleeding, lower abdominal pain, a serum hCG level < 1000 IU/mL, and no signs of intrauterine pregnancy. Results: In 22 of the 24 patients tubal pregnancy was demonstrated with the illuminated rod and removed. Histology confirmed tubal pregnancy. In two patients with no sign of ectopic pregnancy with the illuminated rod curettage was performed and showed missed abortion. Serum hCG levels declined in all patients. Conclusion: The illuminated rod appears useful to detect early tubal pregnancies at laparoscopy.