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Ectopic Pregnancy

Kristina Gracey Gracey, MD, MPH Reviewed 06/2022
 


BASICS

DESCRIPTION

Ectopic: pregnancy implanted outside the uterine cavity. Subtypes include: 
  • Tubal: pregnancy implanted in any portion of the fallopian tube. Abdominal: pregnancy implanted intra-abdom...

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

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

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
Diagnosis and management of ectopic pregnancy: Green-top Guideline No. 21. BJOG.  2016;123(13):e15–e55. [View Abstract on OvidMedline]
2
...

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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