What is the gold standard for diagnosing ectopic pregnancy?

Laparoscopy is regarded as the gold standard for diagnosing ectopic pregnancy primarily due to its ability to provide direct visualization of the pelvic structures and, if necessary, allows for immediate intervention. During laparoscopy, a surgeon can inspect the fallopian tubes and ovaries, identify the presence of an ectopic pregnancy, and assess any associated complications such as bleeding.

Transabdominal ultrasound, while useful for initial evaluations, may not always provide sufficient detail to confirm an ectopic pregnancy in all cases, especially in early pregnancy. CT scans are generally not the first-line imaging modality for ectopic pregnancies due to increased radiation exposure and are less effective at visualizing early gestations. MRI, although valuable for certain pelvic pathologies, is not routinely used for the diagnosis of ectopic pregnancy due to its high cost and limited availability compared to laparoscopy.

Thus, the choice of laparoscopy as the gold standard is based on its diagnostic accuracy and the capability for therapeutic intervention at the same time if required.