Rather like signs and symptoms, the investigations available to diagnose acute pelvic inflammatory disease lack sensitivity. Blood tests such as a white cell count, erythrocyte sedimentation rate and C-reactive protein are all relatively non-specific. They may be elevated in pelvic inflammatory disease but in mild cases can be normal. In particular a leukocytosis is often not seen in non-pyogenic infections.
A pregnancy test, preferably measuring serum beta HCG, is mandatory to exclude an ectopic pregnancy and also the possibility of an ovarian accident associated with a very early intrauterine pregnancy. This should always be performed before commencing empirical antibiotic treatment. In most hospitals this is available as an emergency investigation. If it is not, a simple urinary pregnancy test is almost as accurate.
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The first trimester is very important for the mother and the baby. For most women it is common to find out about their pregnancy after they have missed their menstrual cycle. Since, not all women note their menstrual cycle and dates of intercourse, it may cause slight confusion about the exact date of conception. That is why most women find out that they are pregnant only after one month of pregnancy.