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Negative βHCG tubal ectopic pregnancy

The incidence of ectopic pregnancy in the UK is reported as 9:1,000 but worldwide, and especially in developing countries, the incidence is much higher (Collier et al. 1999). About 7% of maternal deaths, 0.3:1,000 are due to ectopic pregnancy (Collier et al. 1999); again these figures are higher in developing countries. Negative urine and serum bHCG are recorded in 3.1% and 2.6%, respectively in cases of ectopic pregnancy (Skinner and Jones 2003). This case highlights difficulties in the diagnosis of ectopic pregnancy, especially when risk factors are present, and reinforces the need for good history and clinical examination combined with other investigations.