The differential diagnosis for women of childbearing potential who present with abdominal or pelvic symptoms or abnormal vaginal bleeding is broad ( T§b!e...l00-1). In these patients, no combination of signs or symptoms has sufficient negative predictive value to rule our ectopic pregnancy. Pregnancy testing is therefore mandatory. If pregnancy is detected, EP should remain part of the differential diagnosis unless another diagnosis can be made with a high level of certainty. When another diagnosis is not made or when EP is considered along with another diagnosis, EP must be ruled out with a combination of laboratory and imaging studies.

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