Epidemiology

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Etiology

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Pathophysiology

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Clinical features

• Lower abdominal pain and guarding (ectopic pregnancy is often mistaken for appendicitis due to the similarity of symptoms)
• Possibly, vaginal bleeding
• Signs of pregnancy
  • Amenorrhea
  • Nausea
  • Breast tenderness
  • Frequent urination
• Tenderness in the area of the ectopic pregnancy
• Cervical motion tenderness, closed cervix
• Enlarged uterus

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Diagnostics

• ↑ β-hCG
• Transvaginal ultrasound (TVUS)
  • Indication: best initial imaging test for determining the location of the pregnancy
  • Supportive findings
    • Empty uterine cavity in combination with a thickened endometrial lining
    • Additional findings in tubal pregnancy
      • Possible extraovarian adnexal mass
      • Tubal ring sign (blob sign): an echogenic ring that surrounds an unruptured ectopic pregnancy
• Endometrial biopsy
  • Mainly affected by hCG induced progesterone

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Treatment

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