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Ectopic Pregnancy

Kristina Gracey Gracey, MD, MPH, Nicole D Somes, MD and Jeremy Golding, FAAFP, MD Reviewed 04/2024
 


BASICS

DESCRIPTION

Ectopic: pregnancy implanted outside the uterine cavity. Subtypes include: 
  • Tubal—pregnancy implanted in the fallopian tube

  • Abdominal—pregnancy implanted intra-abdominally, usually aft...

DIAGNOSIS

HISTORY

In >50% of presenting cases, patients have sudden-onset abdominal pain coupled with cessation of/or irregular menses and acute vaginal bleeding (the classic triad). Other common sy...

TREATMENT

MEDICATION

  • thotrexate: treatment for unruptured tubal pregnancy or for remaining POCs after laparoscopic salpingostomy. Methotrexate inhibits DNA synthesis via folic acid antagonism by inacti...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Serial serum quantitative hCG until level drops to zero: After methotrexate administration, a strict monitoring protocol should be followed. Fol...

REFERENCES

1
Tonick S, Conageski C. Ectopic Pregnancy. Obstet Gynecol Clin North Am. 2022;49(3):537-549. PMID: 36122984.
2
Yuk  JS, Lee  JH, Park  WI, et al. Systematic review and...

ADDITIONAL READING

SEE ALSO

Hajenius PJ, Mol F, Mol PMM, et al. Interventions for tubal ectopic pregnancy. Cochrane Database Syst Rev. 2007;(1):CD000324. DOI: 10...

CODES

ICD10

  • O00.9 Ectopic pregnancy, unspecified

  • O00.1 Tubal pregnancy

  • O00.0 Abdominal pregnancy

  • O00.2 Ovarian pregnancy

  • O00.8 Other ectopic pregnancy

SNOMED

  • 34801009 Ectopic pregnancy (disorder)

  • 79586000 tub...

CLINICAL PEARLS

  • 97% of ectopic pregnancies occur in the fallopian tube.

  • Diagnosis requires high clinical suspicion in the setting of abdominal pain and a positive pregnancy test until IUP is confirmed.

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