# Suspected pregnancy - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - Sources: Ectopic Pregnancy - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK539860/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class WS01 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care - Verified date: 2026-08 ## Verified against - No dose - referral pathway, no medicine given in primary care ## Treatment metadata - No drug therapy in primary care (Recognition & Referral) ## Complete treatment card ```text SUSPECTED PREGNANCY Sources: Ectopic Pregnancy - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK539860/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class WS01 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care Review status: REVIEWED against the source listed above (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (2) - Missed periods, lower abdominal or pelvic pain, or bleeding per vaginam in a woman who could conceive [abdominal pain · bleeding · lower abdominal pain · pelvic pain] - Swab the vaginal fluid if she reports discharge, burning or pain, because a sexually transmitted infection threatens the fetus and complicates the pregnancy TESTS (11) - Send a pregnancy test early in any such woman, and in anyone who is shocked - It is highly sensitive and specific, but know where it falls down - Ultrasound is the imaging of choice this early, being accurate and safe for mother and baby - Read the scan together with the beta-hCG and the whole clinical picture, never alone - The urine test usually turns positive about ten days after the period was missed - It reads falsely negative on dilute urine and on a beta-hCG below about 25 mIU/mL - So use the first urine of the morning, which is the most concentrated - It reads falsely positive on fertility drugs that contain beta-hCG, on some cancers, and on a faulty device - In the early first trimester, a level that roughly doubles over 48 hours is reassuring - Start with the scan through the abdomen, which is less invasive, and a full bladder gives the window - Go through the vagina when the abdominal view is unclear, since it sees a very early pregnancy and the adnexa better IF NOT THIS - what else fits (3) - A positive test does not say where the pregnancy is - ectopic still has to be excluded - Red flag: a raised beta-hCG does not prove the pregnancy is normal or even viable - It is also raised in ectopic and heterotopic pregnancy, in miscarriage, and by abnormal germ cell, placental or embryonal tissue Source StatPearls "Early Pregnancy Diagnosis" - disease-level clinical article Status traced to the source above 1. NO DRUG THERAPY IN PRIMARY CARE (RECOGNITION & REFERRAL)[1st line] Adult A presenting complaint of possible pregnancy (missed period, symptoms) before confirmation; the GP's role is to test and confirm, not to prescribe. - Refer Peds Adult-only condition - paediatric section not applicable Source No dose - referral pathway, no medicine given in primary care Why A presenting complaint of possible pregnancy (missed period, symptoms) before confirmation; the GP's role is to test and confirm, not to prescribe. Caution Suspected pregnancy with severe abdominal pain or bleeding should raise concern for an ectopic pregnancy and needs urgent work-up. No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to. Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)