https://idwiki.org/index.php?action=history&feed=atom&title=Ectopic_pregnancy
Ectopic pregnancy - Revision history
2026-05-13T03:34:32Z
Revision history for this page on the wiki
MediaWiki 1.43.8
https://idwiki.org/index.php?title=Ectopic_pregnancy&diff=4956&oldid=prev
Aidan: Text replacement - "Clinical Presentation" to "Clinical Manifestations"
2020-07-15T12:14:39Z
<p>Text replacement - "Clinical Presentation" to "Clinical Manifestations"</p>
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Aidan
https://idwiki.org/index.php?title=Ectopic_pregnancy&diff=4196&oldid=prev
Maintenance script: Imported from text file
2020-07-04T01:17:33Z
<p>Imported from text file</p>
<p><b>New page</b></p><div>== Definition ==<br />
<br />
* Implantation of a fertilized ovum outside the uterus<br />
<br />
== Etiology ==<br />
<br />
* Failure of tubal transport of the egg<br />
* Often results from infection<br />
* Sites of implantation<br />
** Tubal (95%), especially ampulla<br />
** Interstitial/cornual (2-4%)<br />
** Ovarian, abdominal, cervical (all &lt;1%)<br />
<br />
== Differential diagnosis ==<br />
<br />
* Urogynecological<br />
** Abortion<br />
** Ruptured corpus outrun cyst<br />
** Ovarian torsion<br />
** UTI<br />
* Non-urogynecological<br />
** Pyelonephritis<br />
** Pancreatitis<br />
** Appendicitis<br />
<br />
== Epidemiology ==<br />
<br />
* 2% of all pregnancies<br />
* Increasing prevalence around the world, likely due to improved detection<br />
<br />
== Risk factors ==<br />
<br />
* Previous tubal surgery<br />
* Pelvic inflammatory disease<br />
* Previous ectopic<br />
* IUD?<br />
* IVF<br />
* DES exposure<br />
* STIs<br />
* Contraception with high risk of ectopic<br />
<br />
== Clinical Presentation ==<br />
<br />
* Spotting or bleeding<br />
* Missed menses<br />
* Pain, often unilateral<br />
* Abdominal tenderness +/- adnexal mass<br />
* Building cul-de-sac<br />
<br />
== Investigations ==<br />
<br />
<ul><br />
<li>Beta-hCG<br />
<ul><br />
<li><blockquote><p>1500: check for gestational sac</p></blockquote></li><br />
<li>&lt;1500: repeat with ultrasound</li></ul><br />
</li><br />
<li>Abdominal +/- transvaginal ultrasound<br />
<ul><br />
<li>Adnexal ring sign</li><br />
<li>Ring of fire</li><br />
<li>Pseudogestational sac sometimes seen in uterus, but has irregular borders and no blood flow</li></ul><br />
</li><br />
<li>Progesterone, possibly &lt;5: ectopic or non-viable pregnancy<br />
<ul><br />
<li>5-25: indeterminate</li></ul><br />
<br />
<blockquote><p>25: excludes ectopic</p></blockquote></li><br />
<li>Exploratory laparotomy, if necessary</li></ul><br />
<br />
== Complications ==<br />
<br />
* Rupture<br />
** Presents with increased pain, shock, hypotension, shoulder pain<br />
* Secondary abdominal implantation<br />
* Hemorrhage<br />
* Death<br />
<br />
== Management ==<br />
<br />
* If non-viable fetus, BhCG&lt;15000, no contraindications, and can guarantee appropriate follow up<br />
** Methotrexate IM<br />
** Follow BhCG on days 4-7<br />
** Ideally for &lt;6 weeks gestation and &lt;3.5cm<br />
* Otherwise, and especially if hemodynamically unstable<br />
** Convert a diagnostic laparotomy into a therapeutic<br />
<br />
[[Category:Obstetrical medicine]]</div>
Maintenance script