Rapid Review: Ectopic Pregnancy

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?