[Ectopic pregnancy]

Rob Mooij, Peggy M A J Geomini, Marlies Y Bongers
Nederlands Tijdschrift Voor Geneeskunde 2014, 158: A7831
An ectopic pregnancy is a pregnancy outside of the uterine cavity. An ectopic pregnancy can rupture and lead to hypovolaemic shock due to intraperitoneal bleeding. We describe 3 cases of women with ectopic pregnancy and discuss the diagnostic and therapeutic options. All women of fertile age with abdominal pain or abnormal vaginal bleeding should get a pregnancy test. Vaginal ultrasound and human chorionic gonadotrophin levels are the most important diagnostic tools. Depending on the findings, management can may be either conservative with repeated follow-up, intramuscular methotrexate or surgical, depending on the findings. After an ectopic pregnancy there is a higher risk of subfertility and another ectopic pregnancy, but more than half of the women will have a subsequent ongoing intra uterine pregnancy.

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