Meticulous History and Examination: Still Remains the Backbone of Diagnosis

A high degree of suspicion and an ectopic conscious clinician is required for diagnosis of ectopic pregnancy. Only when you suspect it, a detailed history of the patient and a meticulous examination will reveal the presence of an ectopic pregnancy, which can then be confirmed by the appropriate bedside investigations. The cases of ectopic pregnancy where the diagnosis is delayed or, which are misdiagnosed, carry a high morbidity and mortality, as the morbidity and mortality associated with ectopic pregnancy is directly related to the length of time required for diagnosis. We report three such cases of ectopic pregnancy where the diagnosis was delayed due to variable and unpredictable presentations, in whom the initial history and examination was missed as the presence of ectopic pregnancy was not suspected by the presentation.