Ectopic pregnancy happens when the fertilized ovum implants outside the endometrial lining of the uterus.
Accurate early diagnosis is life-saving, reduces invasive diagnostic procedures & allows conservative treatment that can preserve fertility.
Ectopic pregnancy must be excluded in women of reproductive age w/ a positive pregnancy test, abdominal pain & vaginal bleeding.
Ruptured ectopic pregnancy remains to be the leading cause of maternal mortality in the first trimester.
  1. American College of Emergency Physicians. Clinical policy: critical issues in the initial evaluation and management of patients presenting to the emergency department in early pregnancy. Ann Emerg Med. 2003 Jan;41(1):123-133. PMID: 12514693
  2. Ankum WM. Diagnosing suspected ectopic pregnancy. Hcg monitoring and transvaginal ultrasound lead the way. BMJ. 2000 Nov;321(7271):1235-1236. PMID: 11082067
  3. Barnhart KT. Clinical practice. Ectopic pregnancy. N Engl J Med. 2009 Jul;361(4):379-387. Accessed 11 Feb 2013. PMID: 19625718
  4. Della-Guistina D, Denny M. Ectopic pregnancy. Emerg Med Clin North Am. 2003 Aug;21(3):565-584. PMID: 12962347
  5. Murray H, Baakdah H, Bardell T, et al. Diagnosis and treatment of ectopic pregnancy. CMAJ. 2005 Oct;173(8):905-912. PMID: 16217116
  6. Tay JI, Moore J, Walker JJ. Ectopic pregnancy. BMJ. 2000 Aug;320(7239):916-919. PMID: 10742003
  7. Lipscomb GH, Stovall TG, Ling FW. Nonsurgical treatment of ectopic pregnancy. N Engl J Med. 2000 Nov;343(18):1325-1329. PMID: 11058678
  8. Tenore J. Ectopic pregnancy. Problem-oriented diagnosis. Am Fam Physician. 2000;61:1080-1088
  9. Gabbe S. Ectopic pregnancy. In: Gabbe SG, Niebyl JR, Simpson JL, eds. Obstetrics normal and problem pregnancies. 4th. New York: Churchill Livingstone, Inc; 2002:743-747.
  10. Cunningham F, Macdonald P, et al. Ectopic pregnancy. William's Obstetrics. 20th. Stamford: Appleton and Lange; 1997:607-634.
  11. MedWorm
  12. National Collaborating Centre for Women's and Children's Health commissioned by the National Institute of Health and Clinical Excellence. Ectopic pregnancy and miscarriage: diagnosis and initial management in early pregnancy of ectopic pregnancy and miscarriage. Dec 2012. Accessed 05 Feb 2013.
  13. American College of Obstetricians and Gynecologists (ACOG). ACOG Practice Bulletin No. 94. Medical management of ectopic pregnancy. Jun 2008. Accessed 11 Feb 2013.
  14. Chi TJ. Pregnancy, ectopic. eMedicine. Accessed 11 Feb 2013.
  15. Daiter E. Ectopic pregnancy: overview.
  16. Kelly AJ, Sowler MC, Trinder J. The management of tubal pregnancy. Royal College of Obstetricians and Gynaecologists. Guideline No. 21. May 2004.
  17. Kulp JL, Barnhart KT. Ectopic pregnancy: diagnosis and management. eMedicine. Accessed 11 Feb 2013.
  18. Royal College of Obstetricians and Gynaecologists. The management of tubal pregnancy. May 2004.
  19. Sepillian V, Wood E. Ectopic pregnancy. eMedicine. 2004. Accessed 11 Feb 2013.
  20. Practice Committee of American Society for Reproductive Medicine. Medical treatment of ectopic pregnancy: a committee opinion. Fertil Steril. 2013 Sep;100(3):638-644. doi: 10.1016/j.fertnstert.2013.06.013. Accessed 25 Apr 2014. PMID: 23849842
  21. Elson CJ, Salim R, Potdar N, et al on behalf of the Royal College of Obstetricians and Gynaecologists. Diagnosis and management of ectopic pregnancy: Green-top guideline no. 21. BJOG. 2016 Dec;123(13):e15-e55. doi: 10.1111/1471-0528.14189. PMID: 27813249
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