gynecology and obstetrics
Ectopic Pregnancy
Key Points
Ectopic pregnancy is the implantation of a pregnancy in a site other than the endometrial lining of the uterine cavity; the most common site for ectopic pregnancies is a fallopian tube. Symptoms can include pelvic pain and vaginal bleeding in a pregnant woman, but the woman may not be aware she is pregnant and symptoms may be absent until rupture occurs, sometimes with catastrophic results. Suspect ectopic pregnancy in any female of reproductive age with pelvic pain, vaginal bleeding, or unexplained syncope or hemorrhagic shock. If a urine pregnancy test is positive or clinical findings suggest ectopic pregnancy, determine quantitative serum beta-hCG and do pelvic ultrasonography. Treatment usually involvesmethotrexate, but surgical resection is done if rupture is suspected or criteria are not met formethotrexatetreatment. 