ABSTRACT
This chapter presents a case study of a 26-year-old woman who comes in to the Emergency Department complaining of severe sharp lower abdominal pain, worse on the right-hand side. In a female of reproductive age, this is an ectopic pregnancy until proven otherwise. As there is evidence of haemodynamic compromise, it is likely that this has ruptured and should be managed as a gynaecological emergency in the resuscitation room. A pregnancy test is the first investigation required in all women of reproductive age to determine whether the abdominal pain may be pregnancy or non-pregnancy related. The patient must be taken straight through for immediate resuscitation; laid flat with high flow oxygen through a non-rebreathe facial mask. The patient requires consent for a diagnostic laparoscopy or laparotomy and salpingectomy and a quick transfer to theatre. Anti-D prophylaxis should be offered to all Rhesus-negative women who have a surgical removal of an ectopic or with repeated vaginal bleeding.
