Ectopic Pregnancy

An ectopic pregnancy occurs where a fertilized ovum is implanted in any tissue other than the uterine endometrium. The Royal College of Obstetricians and Gynaecologists estimate that the rate of ectopic pregnancy is 11.1 in 1000. Click the points in the image on the right to identify where an ectopic pregnancy may site.

Patients presenting with abdominal pain and/or vaginal bleeding and a positive urinary βhCG in early pregnancy should be considered to have an ectopic pregnancy until proven otherwise.

The following are more commonly found in patients with ectopic pregnancy:  

• History of previous IUCD
• Infertility
• Previous pelvic surgery
• Tubal ligation
• Presence of peritoneal signs
• Cervical motion tenderness

Special note: Cornual implantation

Patients with cornual implantation may rupture after 12 weeks with catastrophic blood loss. These patients sometimes present with symptoms of gastroenteritis.

No single sign or combination of signs is diagnostic. Half of identified ectopics are in women with no known risk factors.