A 15 YEAR EXPERIENCE WITH ECTOPIC PREGNANCY

  • 1 January 1981
    • journal article
    • research article
    • Vol. 152  (2) , 179-182
Abstract
The increasing importance of an ectopic pregnancy as a cause of maternal death presents a challenge that will be met when primary care physicians combine a high suspicion index with the ability to recognize the patient most at risk. The major symptoms, abdominal pain, secondary amenorrhea and abnormal vaginal bleeding are well known, as are the major signs, abdominal tenderness, adnexal mass and tenderness on cervical motion. Less well known are factors in the clinical history which indicate the patient to be at high risk. These include primary or secondary infertility, previous abortion or ectopic pregnancy and previous tubal operation, either reconstructive or sterilizing. The use of an intrauterine contraceptive device or its recent removal because of abdominal pain or bleeding, or both, is highly significant. Of major importance is a history of recent uterine evacuation. Should an ectopic pregnancy diagnosis be under consideration, procrastination by observation is no longer acceptable. An active effort must be made to confirm or deny the diagnosis. Culdocentesis should be performed in the emergency department or clinic. If positive, prompt laparototomy is indicated. Should the result to culdocentosis be unsatisfactory or negative, laparoscopy should be undertaken without further delay.

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