Ectopic pregnancy

Alternative names:

abdominal pregnancy; cervical pregnancy; tubal pregnancy

Symptoms:

• lower abdominal or pelvic pain
• mild cramping on one side of the pelvis
• amenorrhea (cessation of regular menstrual cycle)
• abnormal vaginal bleeding - usually scant amounts, spotting
• breast tenderness
• nausea
• back pain, low

If rupture and hemorrhaging occurs before successfully treating the pregnancy, symptoms may worsen and include:

• Severe, sharp, and sudden pain in the lower abdominal area
• feeling faint or actually fainting
• referred pain to the shoulder area

Signs and tests:

A pelvic examination may reveal uterine adnexal (Fallopian tube or ovary region) tenderness.

• There is usually a positive pregnancy test.
  • Urine HCG (qualitative) tests may be falsely negative in up to 17.5% of them.
  • In contrast, serum HCG (quantitative) tests have only a 2% incidence of false negative results.

• A hematocrit test may be normal or decreased.
• The white blood count may be normal or increased.
• A culdocentesis may be performed to determine if free blood is present in the abdomen.
• An ultrasound (transvaginal ultrasound or pregnancy ultrasound) illustrates an empty uterus. Products of conception may be evident elsewhere.
• A laparoscopy and or a laparotomy may be necessary for adequate diagnosis.
• A D&C may be indicated to rule out a nonviable intrauterine pregnancy.

This disease may also alter the results of the following tests:

• serum progesterone (found to be less than 15 ng/ml in 80% of women with ectopic pregnancies, to greater than 15 ng/ml in 90% of women with normal intrauterine pregnancies)
• amylase
• urine amylase