Traditionally the diagnosis of ectopic pregnancy was made at surgery and then confirmed on histological examination following salpingectomy. At laparoscopy an unruptured ectopic pregnancy typically presents as a well-defined swelling in the Fallopian tube  (Fig. 14.1). The diagnosis may be difficult in the presence of extensive pelvic adhesions, which impair the visualization of the tubes. Anecdotal cases of false positive and false negative laparo-scopic findings have been reported, but no formal assessment of the accuracy of laparoscopy in the diagnosis of ectopic pregnancy has been published so far. Some authors have advocated the use of dilatation and curettage in the diagnosis of ectopic pregnancy. The presence of chorionic villi helps to provide some reassurance since the incidence of heterotopic pregnancy is relatively low, but as mentioned previously it does not exclude an ectopic. However, the majority of women with absent villi on curettage do not have ectopic pregnancies on subsequent laparoscopies and therefore the diagnostic value of curettage is very limited .
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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.