The Challenge of Ectopic Pregnancy

Ectopic pregnancy (EP) remains the leading cause of maternal death in the first trimester. Risk factors most strongly associated with EP include previous EP and number of prior EPs. The classic symptoms of abdominal pain and/or vaginal bleeding after a period of amenorrhea are nonspecific, and no combination of physical findings can reliably exclude EP. However, early diagnosis of EP can be lifesaving or may reduce the need for an operative procedure. Accurate interpretation of transvaginal ultrasound findings and serum hCG levels is critical to the diagnosis and treatment of EP. Treatment options may vary and include expectant management, medical and/or surgical options. The emotional impact of EP should not be underestimated.