Posterior vaginal vault tenderness is commonly caused by chronic pelvic inflammatory disease, tubal pregnancy miscarriage or rupture. The pathological reason is: when chronic inflammation or tubal pregnancy miscarriage or rupture of fluid accumulation in the area of the posterior dome, can cause peripheral inflammatory reaction, when the gynecological triple diagnosis, can appear in the posterior vaginal dome tenderness. Examination methods: 1, HCG measurement: is currently an important method of early diagnosis of ectopic pregnancy. 2, progesterone determination: ectopic pregnancy serum P level is low, but in 5~10 weeks of pregnancy is relatively stable, a single determination that has a greater diagnostic value, although the normal and abnormal pregnancy serum P level there is cross overlap, it is difficult to determine the absolute threshold between them, but the serum P level is lower than 10 ng/m1 (radioimmunoassay), often suggests an abnormal pregnancy, and its accuracy rate is about 90%. 3.Ultrasonic diagnosis: B-type ultrasonography is especially common for the diagnosis of ectopic pregnancy, vaginal ultrasonography is more accurate than abdominal B-start examination. 4.Diagnostic scraping: when ectopic pregnancy cannot be excluded, diagnostic scraping is feasible to obtain the endometrium for pathologic examination. However, the endometrial changes of ectopic pregnancy are not characteristic, which can be manifested as metaphase tissue, highly secretory phase with or without A?S reaction, secretory phase and proliferative phase. Endometrial changes are associated with the presence or absence of vaginal bleeding and the duration of vaginal bleeding. Thus, diagnostic scraping alone has great limitations in the diagnosis of ectopic pregnancy. 5. Posterior fornix puncture: Posterior fornix puncture is widely used to assist in the diagnosis of ectopic pregnancy, and often the blood can be withdrawn and placed not to coagulate, in which there are small clots. If no fluid is extracted, the diagnosis of ectopic pregnancy cannot be excluded. 6, laparoscopy: in most cases, ectopic pregnancy patients by history, gynecological examination, blood beta;?HCG measurement, ultrasound can be diagnosed after the early ectopic pregnancy, but for some diagnostic difficulties in some cases, under the direct vision of laparoscopy, can be timely and definitive diagnosis, and surgical treatment can be done at the same time. 7, other biochemical markers: Grosskinsky et al. reported that ectopic pregnancy serum AFP level increased, E2 level is low, the two and serum HCG, progesterone joint determination, in the detection of ectopic pregnancy is better than a single determination.