ABSTRACT
Ectopic Pregnancy Symptoms, Signs and Investigation fi ndings Ectopic pregnancy is defi ned as the implantation of an embryo outside of the uterine cavity. It complicates 1% of all pregnancies and represents a major cause of maternal mortality. The most common site for implantation is the inside lining of a Fallopian tube (97%). Other sites include the cornu, cervix, ovary and peritoneum. Ectopic pregnancy should always be suspected in a sexually active woman who presents with bleeding or abdominal pain. Clinical features include a 4-10 week history of amenorrhoea, sudden onset of colicky lower abdominal pain (later becoming constant) and scanty dark vaginal bleeding. Intraperitoneal haemorrhage is heralded by syncopal collapse and shoulder tip pain. The diagnosis is suggested by an empty uterus on ultrasound with a positive pregnancy test (beta-HCG levels). A confi rmed diagnosis is characterised by the presence of a thick, ring-like echogenic centre located outside the uterus, with a gestational sac containing a foetal pole or yolk sac.
