Highlights & Basics
- Ectopic pregnancy typically presents 6 to 8 weeks after the last normal menstrual period, but can present earlier or later.
- Risk of ectopic pregnancy increases with prior ectopic pregnancy, tubal surgery, history of sexually transmitted infections, smoking, in vitro fertilization, or if the woman is pregnant despite IUD usage.
- Classic symptoms and signs of ectopic pregnancy are pain, vaginal bleeding, and amenorrhea. Hemodynamic instability and cervical motion tenderness may indicate rupture or imminent rupture of an ectopic pregnancy.
- If the woman is hemodynamically stable, transvaginal ultrasound is the initial test of choice.
- Treatment approaches for ectopic pregnancy include expectant, medical (methotrexate), or surgical (salpingectomy or salpingostomy).
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Images
Blood in cul de sac
Blood in abdomen
Ultrasound image of ectopic pregnancy
Ultrasound image of ectopic pregnancy
Ultrasound image of ectopic pregnancy
Ultrasound image of ectopic pregnancy showing the "bagel" sign
Ultrasound image of ectopic pregnancy showing the "bagel" sign
Surgical extraction of ectopic pregnancy
Surgical extraction of ectopic pregnancy
Citations
ACOG practice bulletin no. 193: tubal ectopic pregnancy. Obstet Gynecol. 2018 Mar;131(3):e91-103.[Abstract]
Kirk E, Bottomley C, Bourne T. Diagnosing ectopic pregnancy and current concepts in the management of pregnancy of unknown location. Hum Reprod Update. 2014 Mar-Apr;20(2):250-61.[Abstract][Full Text]
Elson CJ, Salim R, Potdar N, et al; Royal College of Obstetricians and Gynaecologists. Diagnosis and management of ectopic pregnancy: Green-top Guideline No. 21. BJOG. 2016 Dec;123(13):e15-55.[Abstract][Full Text]
National Institute for Health and Care Excellence. Ectopic pregnancy and miscarriage: diagnosis and initial management. Nov 2021 [internet publication].[Full Text]
Elson CJ, Salim R, Potdar N, et al; Royal College of Obstetricians and Gynaecologists. Diagnosis and management of ectopic pregnancy: Green-top Guideline No. 21. BJOG. 2016 Dec;123(13):e15-e55.[Abstract][Full Text]
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51. Connolly A, Ryan DH, Stuebe AM, et al. Reevaluation of discriminatory and threshold levels for serum beta-hCG in early pregnancy. Obstet Gynecol. 2013 Jan;121(1):65-70.[Abstract]
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