Ectopic Pregnancy

About Ectopic Pregnancy

Ectopic pregnancy occurs when a fertilized embryo implants outside the uterine cavity, most commonly in the fallopian tube (95% of cases). This condition affects approximately 1-2% of all pregnancies and represents a potentially life-threatening emergency requiring immediate medical intervention. Early diagnosis and treatment are crucial to prevent rupture and massive internal bleeding.

Pathophysiology

Ectopic pregnancy typically results from impaired embryo transport through the fallopian tube due to structural abnormalities, inflammation, or hormonal factors. Risk factors include previous pelvic inflammatory disease, prior ectopic pregnancy, tubal surgery, and assisted reproductive technologies. As the embryo grows in the confined tubal space, it can cause tubal rupture, leading to hemoperitoneum and hemodynamic instability.

Clinical Reasoning

Patients typically present with the classic triad of amenorrhea, abdominal pain, and vaginal bleeding, though this complete presentation occurs in only 45% of cases. Serial beta-hCG levels that fail to double appropriately every 48-72 hours, combined with transvaginal ultrasound findings, guide diagnosis and management decisions. Treatment options include methotrexate for stable, unruptured cases or surgical intervention (salpingostomy or salpingectomy) for ruptured or high-risk presentations.