Ectopic Pregnancy

An ectopic pregnancy is a feared complication of early pregnancy defined by the implantation of an embryo at any site outside of the expectant uterus. It is a leading cause of maternal death. Most patients will present to the emergency setting with complaints of abdominal/pelvic pain or vaginal bleeding; many patients may not even know they are pregnant at the time of visitation. A fetus implanted outside of the uterus in general cannot survive and will lead to fetal demise, but early detection and treatment can prevent life-threatening maternal hemorrhagic shock or septic shock and preserve future reproduction possibilities. Definitive diagnosis can only be made by identification of an intrauterine pregnancy without suspicion of abnormal extrauterine structures. Ultrasound is typically the modality of diagnosis. The key in emergency care is diagnosis. Management can be coordinated with an obstetrics or gynecology specialist and can include medical management or surgical management.