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Ectopic pregnancy is a complication of pregnancy in which the embryo attaches outside the uterus. [5] Signs and symptoms classically include abdominal pain and vaginal bleeding, but fewer than 50 percent of affected women have both of these symptoms. [1]
Nontubal ectopic pregnancy refers to an ectopic pregnancy that occurs in the ovary, cervix, or intra-abdominal cavity. Other causes of early pregnancy bleeding include the following: Postcoital bleeding , which is vaginal bleeding after sexual intercourse that can be normal with pregnancy.
The use of this method can be limited due the location of the ectopic pregnancy and the experience of the physician with this technique. Treatment of heterotopic pregnancy will depend on the specific location of the ectopic pregnancy, as well as the pregnant person's clinical presentation and stability. [6]
A cervical pregnancy is an ectopic pregnancy that has implanted in the uterine endocervix. [2] Such a pregnancy typically aborts within the first trimester , however, if it is implanted closer to the uterine cavity – a so-called cervico-isthmic pregnancy – it may continue longer. [ 3 ]
No treatment is necessary for a diagnosis of complete miscarriage (so long as ectopic pregnancy is ruled out). In cases of an incomplete miscarriage, empty sac, or missed abortion there are three treatment options: watchful waiting, medical management, and surgical treatment.
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Ovarian pregnancy refers to an ectopic pregnancy that is located in the ovary. Typically the egg cell is not released or picked up at ovulation, but fertilized within the ovary where the pregnancy implants. [1] [2] [3] Such a pregnancy usually does not proceed past the first four weeks of pregnancy. [3]
A sensitive serum pregnancy test is typically obtained to rule out ectopic pregnancy. Culdocentesis will differentiate hemoperitoneum (ruptured ectopic pregnancy or hemorrhagic cyst) from pelvic sepsis (salpingitis, ruptured pelvic abscess, or ruptured appendix). [28] Pelvic and vaginal ultrasounds are helpful in the diagnosis of PID.
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