An ectopic pregnancy occurs
when a fertilized egg
implants outside of the
uterine cavity, most
commonly in the fallopian
tube. As the pregnancy
grows, it can cause the tube
to burst and rupture leading
to a major internal
bleeding.
• Abdominal pain, lower back pain,
Vaginal bleeding, and Missed
menstrual period (amenorrhea).
Clinical
Manifestations
• Patients may present with
other symptoms common to
early pregnancy, including
nausea, breast fullness,
fatigue, low abdominal pain,
heavy cramping, shoulder
pain, and recent
dyspareunia. Painful fetal
movements (in the case of
advanced abdominal
pregnancy), dizziness or
weakness, fever, flulike
symptoms, vomiting.
• History of pelvic inflammatory disease
(PID)
Risk factors
for ectopic
pregnancy:
• Previous ectopic pregnancy
• Tubal surgery
• Infertility treatments
• Cigarette smoking
• Intrauterine device (IUD) use
• History of tubal ligation
• Certain sexually transmitted
infections.
• Age older than 35 years.
• Important considerations regarding symptoms:
• Symptoms can vary significantly, with some patients
experiencing only mild discomfort or presenting with no
symptoms at all.
• Shoulder pain can be a presenting symptom due to irritation
of the diaphragm from blood in the peritoneal cavity.
Diagnoses
for Ectopic
pregnancy
• Perform a pelvic exam
• Perform an ultrasound (Transvaginal ultrasound); to see where the pregnancy is developing
• Serial beta-hCG levels: Test your blood for a pregnancy hormone called human chorionic
gonadotropin (hCG).
Treatment and
management of
ectopic pregnancy
• Medication methotrexate may be used if the pregnancy has not ruptured a fallopian tube.
• If the ectopic pregnancy has ruptured a tube, emergency surgery is needed. Sometimes surgery
is needed even if the fallopian tube has not ruptured.
• In the case where the ectopic pregnancy is removed from the tube while preserving the tube,
Salpingostomy is done. If the entire tube with the pregnancy can is removed, salpingectomy is
done.
• Risk for excess bleeding,
Priority
problem with
Ectopic
pregnancy
• Acute pain,
• Ineffective tissue perfusion,
• Deficient fluid volume,
• Risk of infection,
• Shock and fatigue,
• Grieving and hopelessness,
• Ineffective coping,
• Fear of never having
biological children
Assessmen
t and
intervent
ion
Monitor vital
signs.
Increase
comfort.
Discuss
procedures
(Surgical or
pharmacological)
Administer
medications as
required.
Monitor input and
output.
Monitor
activities if bed
rest is ordered.
Refer/connect
with grief
support
counselor/groups.