Document Detail

Hemorrhagic shock from a ruptured ectopic pregnancy in a patient with a negative urine pregnancy test result.
MedLine Citation:
PMID:  12085079     Owner:  NLM     Status:  MEDLINE    
Ectopic pregnancy has been increasing in frequency over the past 2 decades. The sudden rupture of a fallopian tube caused by ectopic pregnancy can lead to hemorrhagic shock and death if not diagnosed and treated in a timely fashion. The emergency physician is often the health professional that is called on to make the diagnosis and coordinate timely and effective intervention. The first step in the diagnosis of ectopic pregnancy is demonstration of pregnancy by means of a rapidly performed and sensitive qualitative urine test for the beta-subunit of human chorionic gonadotropin (beta-hCG). A negative urine pregnancy test result will generally be used to exclude ectopic pregnancy from further consideration. The following is a report of a patient presenting to an emergency department with hypovolemic shock in conjunction with 2 negative urine beta-hCG analysis results and a quantitative serum beta-hCG level of 7 mIU/mL, a value less than the lower limit of detection for the highly sensitive qualitative urine and serum tests. This case report demonstrates the importance of further consideration of the diagnosis of ectopic pregnancy in the setting of a negative urine pregnancy test result.
Michelle A Kalinski; David A Guss
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Annals of emergency medicine     Volume:  40     ISSN:  0196-0644     ISO Abbreviation:  Ann Emerg Med     Publication Date:  2002 Jul 
Date Detail:
Created Date:  2002-06-26     Completed Date:  2002-07-31     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8002646     Medline TA:  Ann Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  102-5     Citation Subset:  AIM; IM    
Department of Emergency Medicine, University of California-San Diego Medical Center, San Diego, CA, USA.
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MeSH Terms
Chorionic Gonadotropin, beta Subunit, Human / blood
False Negative Reactions
Pregnancy Tests / methods*
Pregnancy, Tubal / complications*,  diagnosis*,  surgery
Rupture, Spontaneous / complications
Shock, Hemorrhagic / etiology*
Urinalysis / methods
Reg. No./Substance:
0/Chorionic Gonadotropin, beta Subunit, Human

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