The other day, in the emergency class, more than a dozen patients with ectopic pregnancy were admitted during the week, and they were busy day and night! I can’t help but reflect on the fact that in the capital city where medical conditions are good, it is not difficult to diagnose ectopic pregnancy, a urine test, a blood draw, or an ultrasound can clarify the situation. It seems that people may have overlooked something (including patients and medical staff)! Phenomenon 1: I’ve been sterilized! It is impossible to get pregnant. A common form of sterilization is tubal ligation, but the human body is amazing, and the tubes occasionally reopen after ligation! So it’s not surprising that you get pregnant after a ligation or even an ectopic pregnancy! Phenomenon 2: I have already had a tubectomy, how can I have an ectopic pregnancy when my fallopian tubes are gone? Some patients have undergone tubectomy for various reasons, but when the tubes are removed, they are often cut off from the isthmus and the interstitial part, but in fact there is still a small part of the tubes connected to the uterine cavity. I have been practicing medicine for almost 20 years and have encountered one case. Phenomenon 3: I have the IUD in place! How can I get pregnant? Although the IUD is a long-acting contraceptive method, no contraceptive method has been able to achieve a 100% success rate so far, and even if the IUD has been placed, pregnancy or ectopic pregnancy symptoms should be ruled out! Phenomenon 4: What about wearing a condom during sex! There are also techniques to use condoms! To choose the right size, to pay attention to the time to wear, to remove in time after sex, to check the integrity after removal, etc.! Otherwise, the annoying autumn wind may still blow you! Phenomenon 5: I used the emergency contraceptive pill afterwards! It should be fine! Let’s not talk about whether the emergency contraceptive pill will increase the chance of ectopic pregnancy, after applying it, there may be changes in menstruation, irregular vaginal bleeding, etc. We must think about the possibility of ectopic pregnancy! The emergency contraceptive pill Yuktin, which is commonly used in the market, has been mentioned in the latest instructions to pay attention to the occurrence of ectopic pregnancy. Phenomenon 6: I have not been pregnant since I have been married for many years, and the doctor said I could not have gotten pregnant on my own! There are various reasons for infertility, and just because you couldn’t get pregnant before doesn’t mean you can’t get pregnant afterwards! I have a very good friend who has been married for many years and is infertile, so she doesn’t want to have a baby on purpose, she just goes with the flow and doesn’t use contraception. She suddenly called me in the early hours of the morning with abdominal pain, and immediately asked me to check her urine urgently, which was positive. Phenomenon 7: I am almost menopausal, my menstruation is irregular, I am basically infertile, and I have had very little sex. I often hear this from older women in their forties when I go to the clinic. During perimenopause, although ovarian function decreases, ovulation is irregular, and the ability to conceive decreases, it is more difficult to calculate the time of ovulation to prevent pregnancy, coupled with menstrual disorders, menopause, etc., until symptoms appear, it is too late to regret. After the college entrance examination, I admitted such a patient, her husband worked abroad, her son had abdominal pain during the college entrance examination, which she endured for many days, and only after the examination was over, her family found her fainted in the bathroom and came to the clinic, bleeding 2500 ml! Fortunately, save life! Phenomenon eight: young people have a lot of like safe period contraception! The old saying is that the safe period is not safe! God knows when to ovulate! A friend of mine, who is also a medical student, always had doubts about the timing of his wife’s pregnancy: I remember those days were safe! There is no other problem, right? I scolded him: You’re still a medical student! Safe periods are not safe! It wasn’t until his son was born that his doubts were dispelled. The above phenomenon is a common problem that patients often ignore! There are also problems that doctors tend to ignore one of them: a negative urine test! The chief of our department often says: don’t dismiss the diagnosis of ectopic pregnancy just because the urine pregnancy test is negative! This is because ectopic pregnancy often has low HCG levels due to the site of implantation and embryonic development, especially in early pregnancy or when the patient does not keep morning urine for the test! If there are other symptoms of ectopic pregnancy, it would be more accurate to check the blood HCG if necessary! Secondly, the patient has already had an abortion or a medication abortion outside the hospital and still has continuous bleeding or abdominal pain. In this case, trust your own judgment and don’t be induced by previous medical history, it is not complicated to check HCG and ultrasound again! Thirdly, the presence of other medical and surgical symptoms, and the fact that the first visit may not be to an obstetrician or gynecologist, makes it easier to misdiagnose and miss the diagnosis! For example, a history of appendicitis may lead to pain in the right lower abdomen; a history of chronic gastritis may lead to pain in the stomach area with vomiting and vomiting; and various stones and pelvic inflammatory diseases may make the emergency physician overlook the diagnosis of ectopic pregnancy. A typical ectopic pregnancy can be easily diagnosed even by an intern! A difficult ectopic pregnancy can capsize an old specialist! Only if both doctors and patients share some of these concerns can tragedies happen less and less in gynecology! Remember, ectopic pregnancy can happen to any woman of childbearing age, not just unmarried girls!