Rapid Review: Ectopic Pregnancy

October 19, 2017
Reviewed By: Amy Rontal

Ectopic Pregnancy

  • Patient will be a woman
  • With a history of prior ectopic, PID, tubal surgery, IUD
  • Complaining of vaginal bleeding, abdominal pain, amenorrhea
  • PE will show adnexal tenderness or unexplained hypotension
  • Labs will show positive pregnancy test and lower than expected serum beta-hCG levels
  • Diagnosis is made by ultrasound
  • Most commonly located in a fallopian tube
  • Treatment is MTX or surgery

Sample question:

A 44-year-old woman with a history of hypertension presents to her primary care provider’s office with complaints of nausea and vomiting. Her last menstrual cycle was six weeks ago. Two years ago she had a bilateral tubal ligation performed. On physical exam, her abdomen is nontender and her uterus is not enlarged. Pelvic exam is unremarkable. Her serum human chorionic gonadotropin level is 5,000 mIU/mL. A transvaginal ultrasound does not demonstrate an intrauterine gestational sac. Which of the following is the most likely diagnosis?

By Yehuda Wolf, MPA, PA-C

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