Definition
An ectopic pregnancy is a non-viable pregnancy resulted from a fertilised ovum implanting in a site other than the endometrium.
Etiology- Anatomical blockage or change to uterine tract motility
- IVF
- Use of intrauterine device
- PHx of uterine tubal procedures
- Endometriosis
- Pelvic Inflammatory Disease
- PV bleeding or spotting
- Lightheadedness ± syncope
- Pain (pattern according to the gestation week)
- <6 weeks gestation:
- Vague crampy or steady
- Can be unilateral or bilateral
- >6 weeks gestation:
- Specific constant & severe
- Usually unilateral on side of implantation
- Referral pain to shoulder tip or flank
- <6 weeks gestation:
- Positive pregnancy test
- Quantitative hCG
- FBE
- Transvaginal ultrasound
- Immediate diagnostic laparoscopy ± laparotomy for haemodynamically unstable patients
- Anti-D immunoglobulin for all Rh negative women
- IM Methotrezate to expel uterine contents
- Salpingectomy or salpingostomy if required
