For severe pain you should always present to the Emergency Department of your nearest hospital if you cannot contact your doctor. [alanahealthcare.com.au]

Consider ectopic when a patient presents with syncope and has a positive BhCG. [emergencymedicinecases.com]

Patients frequently present with benign examination findings, and adnexal masses are rarely found. [emedicine.medscape.com]

Abdominal examination: Cullen’s sign: a periumbilical bluish discoloration may be present due to absorption of the blood in the peritoneal cavity by lymphatics. It is a late sign. [gfmer.ch]

Delayed capillary refill and cool clammy skin may also be present. Class III hemorrhage involves a 30 to 40 % blood volume loss. [link.springer.com]

• Internal Bleeding

  Shock If the fallopian tube ruptures, a woman will have internal bleeding and may go into shock from all of the bleeding. Ectopic pregnancies can be life-threatening. [justmommies.com]

  This pain occurs when the internal bleeding irritates organs such as the diaphragm Collapsing or shock mainly due to internal bleeding Profuse sweating and faintness It’s important to note that sometimes the woman may not experience these symptoms especially [newkidscenter.com]

  Pain at the very tip of the shoulder, where the shoulder ends and the arm begins, is a signal of specific internal bleeding. [bustle.com]

  […] please help Wow, I had internal bleeding due to ectopic pregnancy, doctors did emergency surgery to me with in an hour after I went into the hospital, still I lost one liter blood due to internal bleeding, don't wait too long go to ER immediately after [medhelp.org]

  If not treated, there is a risk of heavy internal bleeding due to rupturing of the fallopian tube. [womenonweb.org]

• Infertility

  […] may be due to: A history of PID Previous ectopic pregnancy Past surgeries involving the fallopian tubes Endometriosis Exposure to DES ( diethylstilbestrol ) in utero Bicornuate uterus Non‑anatomical risk factors Intrauterine device ( IUD ) History of infertility [amboss.com]

  Infertility: occurs in 10-15% of women with history of ectopic pregnancy. [layyous.com]

  Infertility The possibility of being infertile is high for women who have damaged or blocked fallopian tubes. Situations get worst when the ectopic pregnancy becomes ruptured. [webmedicinecenter.com]

  Infertility occurs in 10% to 15% of women who have had an ectopic pregnancy. [knowhen.com]

• Severe Pain

  For bleeding or severe pain after 20 weeks, call your hospital and they will give you instructions on what to do. [drchrisrussell.com.au]

  The most common symptoms arising from ectopic pregnancy are pain and/or vaginal bleeding during early pregnancy. The pain associated with an ectopic pregnancy can be mild or severe. [alanahealthcare.com.au]

  […] cause severe pain while you are having a bowel movement, especially if you are straining. [summitmedicalgroup.com]

  Other symptoms of an ectopic pregnancy include severe pain down one side of your abdomen, feeling faint and nausea. The pain may suddenly disappear if the tube ruptures but it will return soon enough and you will feel very unwell. [bounty.com]

  If you have sudden or ongoing severe pain in your belly or back (mostly on one side), if you feel you might faint or if you do faint, or if you feel pain in the shoulder area, you might have an ectopic pregnancy that has burst and you should go to a hospital [womenonweb.org]

• Falling

  Because progesterone keeps the growing uterine lining intact and falling levels are responsible for initiating menstrual bleeding, lower than normal levels of progesterone lead to the breakdown of the built-up uterine lining. [livestrong.com]

  (Surface area based on a height and weight algorithm) Quantitative HCG day #4 and day #7 HCG levels should fall >15% from day #4 to #7 If HCG levels don't fall >15%, then give second dose of methotrexate At least half of these patients will have significant [brooksidepress.org]

  If an embryo is located outside the uterus, a treatment plan is made based on the mother's overall health, where the embryo is located, and the mother's hCG levels (a falling level can indicate that the pregnancy is resolving on its own). [everydayhealth.com]

• Pallor

  Signs General examination: Rapidly developed shock, with pallor, sweating, air hunger, rapid thready pulse and hypotension. [gfmer.ch]

• Abdominal Pain

  In addition to signs of pregnancy, symptoms include abdominal pain and vaginal bleeding. [amboss.com]

  If the bleeding continues or if you have any other concerning symptoms, such as fever or abdominal pain, you should seek emergency medical attention. [zocdoc.com]

  The most common symptoms are the combination of a missed period and abdominal pain. [familydoctor.co.nz]

  Women with an ectopic pregnancy may have irregular bleeding and pelvic or belly (abdominal) pain. The pain is often just on one side. Symptoms often appear 6 to 8 weeks after the last normal menstrual period. [cedars-sinai.edu]

  I'm suffering abdominal pain – is this an ectopic pregnancy? Munira said: "Abdominal pain during early pregnancy can be due to many things but it can be a common symptom of an ectopic pregnancy. [closeronline.co.uk]

• Abdominal Cramps

  Other common symptoms of ectopic pregnancy include: Nausea and vomiting with pain Sharp abdominal cramps Pain on one side of your body Dizziness or weakness Pain in your shoulder, neck, or rectum When to Call 911 Ectopic pregnancy can cause a fallopian [webmd.com]

  Contact your doctor if vaginal bleeding is heavier than your usual menstruation, if it lasts longer than a day, if it is accompanied by severe abdominal cramps or if you experience it in the second or third trimester. [modernmom.com]

  Vaginal bleeding, especially if accompanied by abdominal cramps, may be a sign of miscarriage, and is classified as a “threatened miscarriage” or an “inevitable miscarriage.” [onemedical.com]

  Other signs of preterm labor include the following: Change in vaginal discharge (it becomes watery, mucus-like, or bloody) or increase in amount of vaginal discharge Pelvic or lower abdominal pressure Constant, low, dull backache Mild abdominal cramps [acog.org]

  Cramps may also get worse during active movement and even coughing. The cramps can be mild and severe and are usually felt on one side only but can occur anywhere in the abdominal and pelvic area. [webmedicinecenter.com]

• Cullen's Sign

  Abdominal examination: Cullen’s sign: a periumbilical bluish discoloration may be present due to absorption of the blood in the peritoneal cavity by lymphatics. It is a late sign. [gfmer.ch]

• Acute Abdomen

  Tubal rupture Acute course with sudden and severe lower abdominal pain ( acute abdomen ) Signs of hemorrhagic shock : e.g., tachycardia, hypotension, syncope More common in interstitial pregnancy References: [10] [11] [12] Diagnostics Positive pregnancy [amboss.com]

• Abdominal Distension

  Some patients, however, may show some of these findings: Pelvic mass (either from the enlarged ectopic, or from the corpus luteum cyst that accompanies many early pregnancies of all types) Pelvic tenderness, localized or geeralized Abdominal distension [brooksidepress.org]

• Tachycardia

  Tubal rupture Acute course with sudden and severe lower abdominal pain ( acute abdomen ) Signs of hemorrhagic shock : e.g., tachycardia, hypotension, syncope More common in interstitial pregnancy References: [10] [11] [12] Diagnostics Positive pregnancy [amboss.com]

  […] however, may show some of these findings: Pelvic mass (either from the enlarged ectopic, or from the corpus luteum cyst that accompanies many early pregnancies of all types) Pelvic tenderness, localized or geeralized Abdominal distension Hypotension, tachycardia [brooksidepress.org]

  Unilateral or bilateral abdominal or pelvic tenderness - Usually much worse on the affected side Abdominal rigidity, involuntary guarding, and severe tenderness, as well as evidence of hypovolemic shock, such as orthostatic blood pressure changes and tachycardia [emedicine.medscape.com]

• Acne Vulgaris

  vulgaris, infertility Ultrasound shows enlarged ovaries with numerous anechoic cysts. [amboss.com]

• Fear

  Jenny’s fears about her fertility seemed to be confirmed after a further two and a half years of trying, without success, for a baby. [ectopicireland.ie]

  Many women fear that removing one tube will halve their fertility; this is absolutely not the case. Fertility is reduced by about 1/6 because it is possible to ovulate from one ovary and the egg travel down the opposite tube. [drchrisrussell.com.au]

  Experts warn that any sort of fear during pregnancy may be picked up by your unborn baby (this will in turn affect your child’s future). [implantationspotting.net]

  I was dizzy and felt as though my life was over-no golden light or angels visiting, just pure fear. I couldn't breathe and I was slipping away. The paramedic arrived, gave me oxygen and shipped me to my nearest A&E. [aims.org.uk]

  A segmental resection may be needed if there is persistent bleeding of a tube or there is a large fear of leaving residual ectopic tissue behind. [ivf1.com]

• Grieving

  Stillbirth: How to be there for someone who has lost a baby READ: 10 beautiful stillbirth & miscarriage poems to help grieving mothers Mother’s Day after miscarriage or stillbirth: Advice on how to cope and grieve If you or a loved one need any comfort [closeronline.co.uk]

  Give yourself time to grieve. Remember that many women go on to have healthy pregnancies and babies. When you’re ready, talk to your doctor about ways you can ensure that your future pregnancy is a healthy one. [healthline.com]

• Adnexal Mass

  Patients frequently present with benign examination findings, and adnexal masses are rarely found. [emedicine.medscape.com]

  These women should be haemodynamically stable, be able to comply with treatment and follow-up, ideally have an hCG 7,15 and an adnexal mass 2 ), with 14% of women requiring a further dose. [racgp.org.au]

  […] cyst: 10% chance of an ectopic complex extra-adnexal cyst/mass: 95% chance of a tubal ectopic (if no IUP) an intra-adnexal cyst/mass is more likely to be a corpus luteum solid hyperechoic mass is possible but non-specific tubal ring sign 95% chance of [radiopaedia.org]

  Physical examination findings in ectopic pregnancy (5): Abdominal tenderness (80-90%) Adnexal tenderness (75-90%) Adnexal mass (50%) Uterine enlargement (25%) Orthostasis (10%) Pelvic exams can be completely normal. [emergencymedicinecases.com]

  Unfortunately, this 'adnexal mass' is an unreliable sign: doctors may miss them and sometimes feel them on the opposite side to the ectopic pregnancy! [familydoctor.co.nz]

• Metrorrhagia

  Endometrial polyp Irregular menstrual bleeding, spotting, menorrhagia Malignant neoplasms (e.g., cervical cancer, endometrial cancer ) Cervical cancer : menometrorrhagia, postcoital spotting, abnormal vaginal discharge Endometrial cancer : metrorrhagia [amboss.com]

Patients need a full workup for ectopic rupture: hematocrit, BhCG, and ultrasound to look for bleeding. If there are any signs of rupture, urgent OB consult is needed. [emergencymedicinecases.com]

A workup will generally be ordered, including beta hCG levels and ultrasound examinations to determine the location and viability of the pregnancy. [wehavekids.com]

What are the treatments for ectopic pregnancy? There are three possible types of treatment for ectopic pregnancy: 1. Conservative treatments (observation) 2. Medical treatments (medications such as methotrexate) 3. [alanahealthcare.com.au]

Ectopic pregnancy treatment An ectopic pregnancy must be treated in order to stop its growth and prevent complications. Treatment is broadly divided into medical treatment and surgical treatment. 1. [philipthomas.com.au]

Support is also provided throughout the treatment period and after treatment. [newkidscenter.com]

You do not need this injection though if you receive medical treatment. The above is a brief description of treatment options. A gynaecologist will advise on the pros and cons of each treatment with you. [patient.info]

Medical treatment of Ectopic Pregnancy The success rate of medical treatment is 80-90%. [layyous.com]

Ectopic pregnancy: etiology, pathology, diagnosis, management, fertility prognosis. In: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Comprehensive Gynecology. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 17. Nelson AL, Gambone JC. [medlineplus.gov]

General complications for a typical (tubal) ectopic pregnancy include: tubal rupture : 15-20% Treatment and prognosis Management depends on the location of the ectopic pregnancy and the patient's hemodynamic status. [radiopaedia.org]

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. [wehavekids.com]

Ectopic pregnancy: etiology, pathology, diagnosis, management, fertility prognosis. In: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Comprehensive Gynecology. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 17. Nelson AL, Gambone JC. [medlineplus.gov]

Etiology Localization Fallopian tube (96% of cases): ampulla >> isthmus > fimbriae > interstitial pregnancy : e.g., cornual pregnancy Ovary (3% of cases) Abdomen (1% of cases) Cervix (very rare) Risk factors Anatomic alteration of the fallopian tubes [amboss.com]

Ectopic pregnancy after hysterectomy: a review and insight into etiology and prevention. Fertil Steril. 2010 Jul. 94(2):431-5. [Medline]. Peterson HB, Xia Z, Hughes JM, Wilcox LS, Tylor LR, Trussell J. [emedicine.medscape.com]

This bleeding will be both vaginal and internal and has two discrete pathophysiologic mechanisms. External bleeding is due to the falling progesterone levels. Internal bleeding is due to hemorrhage from the affected tube. [knowhen.com]

Ectopic Pregnancy Prevention Many ectopic pregnancies cannot be prevented, but some of those caused by PID may be preventable. [everydayhealth.com]

Not all ectopic pregnancies can be prevented, but reporting any suspicious symptoms right away to your provider can help prevent serious problems. Developed by RelayHealth. Published by RelayHealth. [summitmedicalgroup.com]

Prevention There's no way to prevent an ectopic pregnancy, but here are some ways to decrease your risk: Limit your number of sexual partners. [mayoclinic.org]

Ectopic pregnancy cannot be prevented. [babyhopes.com]

Prevention of Ectopic Pregnancy Ectopic pregnancy cannot be prevented but there are important points that should be considered to decrease the incidence of (PID) which as previously mentioned increases the incidence of ectopic pregnancy. 1. [layyous.com]