Ectopic Pregnancy
An ectopic pregnancy (EP) occurs when a fertilized ovum implants outside the endometrial lining of the uterus. An EP is also referred to as an abdominal pregnancy (1-2%), cervical pregnancy (0.5%), interstitial pregnancy (2-3%), ovarian pregnancy (1%), and tubal pregnancy (97%). An EP occurs in 1-2% of all pregnancies and accounts for 13% of maternal deaths. There is an increasing number of EPs in the US-17,800 cases reported in 1970 and 108,000 cases reported in 1992. Risk factors include previous salpingitis, previous EP, previous tubal ligation, previous tuboplasty, intrauterine device use, progestin-only pill, and assisted reproductive techniques.
Etiology
Etiology
- Anatomic obstruction to zygote passage
- Abnormalities in tubal motility
- Transperitoneal migration of the zygote
Physical Findings & Clinical Presentation
- Adnexal tenderness: 87% to 99%
- Peritoneal signs: 71% to 76%
- Adnexal mass: 33% to 53%
- Enlarged uterus: 6% to 30%
- Shock: 2% to 17%
- Amenorrhea or abnormal vaginal bleeding: 75%
- Shoulder pain: 10%
- Tissue passage: 6% to 7%