Should patients who are suspected of having an ectopic pregnancy undergo physical examination?

Ben W.J. Mol*, Petra J. Hajenius, Simone Engelsbel, Willem M. Ankum, Fulco Van Der Veen, Douwe J. Hemrika, Patrick M.M. Bossuyt

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

25 Citations (Scopus)


Objective: To determine whether physical examination is useful for patients with suspected ectopic pregnancy (EP) for whom transvaginal sonography is performed and serum hCG levels are measured. Design: Prospective study. Setting: Two large teaching hospitals. Patient(s): Three hundred eighty-two patients with suspected EP, based on a positive urine pregnancy test and the presence of abdominal pain, vaginal bleeding, or risk indicators. Intervention(s): Abdominal examination, speculum inspection, and digital vaginal examination. Main Outcome Measure: A final diagnosis made by transvaginal sonography, serum hCG measurement, and, if necessary, confirmatory laparoscopy. Result(s): One hundred sixteen (30%) of the 382 patients had an EP. At external abdominal examination, rebound tenderness and muscular rigidity had likelihood ratios of 3.7 and 8.0, respectively. Findings at speculum inspection and digital vaginal examination had likelihood ratios between 0.33 and 2.4. Logistic regression analysis showed that the additional information provided by physical examination for the diagnosis of EP is limited compared with the information provided by transvaginal sonography and serum hCG measurement alone. Conclusion: On the basis of our results, we believe that vaginal digital examination for patients with suspected EP is unnecessary.

Original languageEnglish
Pages (from-to)155-157
Number of pages3
JournalFertility and Sterility
Issue number1
Publication statusPublished - 1 Jan 1999


  • Diagnosis
  • Ectopic pregnancy
  • Physical examination


Dive into the research topics of 'Should patients who are suspected of having an ectopic pregnancy undergo physical examination?'. Together they form a unique fingerprint.

Cite this