Ectopic Pregnancy

Clinical Description

Pregnancy outside the uterine cavity. The fallopian tube is the common site for ectopic

Pregnancy

Signs and Symptoms

• Often presents as ruptured
• Signs of hemorrhagic shock (low BP, high PR, confusion)
• Abdominal distension/tenderness
• Pain / tenderness in the iliac fossae
• PT positive
• USS: empty uterus
• Complex mass in the adnexa
• Free fluid in the abdomen/POD

Investigations

• Urine pregnancy test
• Ultrasound, FBC, Blood grouping save / crossmatch

Non-pharmacological

• Management: ABCDE approach
• Explain diagnosis and management to the patient
• If at the health Centre, refer immediately to the hospital after the above and communicate to the referral Centre

Pharmacological

• Insert 2 large bore IV cannula, take FBC and group and cross match samples, start

Ringer’s Lactate or normal saline, catheterise

At Hospital:

• If first presentation is at the hospital, manage patient as above plus
• FBC, group and cross match
• Laparotomy stat (salpingectomy). Do not wait for resuscitation
• Cover for chlamydia with Doxycycline 100mg 12 hourly for 7 days
• Explain diagnosis and management to the patient