An ectopic pregnancy is a medical emergency. If you think you have an ectopic pregnancy you should seek immediate medical attention without delay. This may be either at your General Practitioner’s surgery or in a hospital setting.
If you think you have an ectopic pregnancy and visit your GP…
If you think you have an ectopic pregnancy and visit your GP, they will take a history, assess your condition and possibly take a urine pregnancy test. If ectopic pregnancy could be a potential diagnosis, you will be referred without delay to the hospital.
If you or your GP suspect an ectopic pregnancy and go to the hospital…
If you think you have an ectopic pregnancy and visit the hospital, history will be taken about your symptoms and risk factors for ectopic pregnancy. Examination may include pulse and blood pressure checks, abdominal palpation and possibly a vaginal examination.
Depending on the findings, further specialist investigations will be undertaken. You would usually have a cannula inserted into your arm (a drip) in case you need to be given fluids should your blood pressure be low.
The blood tests would include a full blood count, a blood group and a blood pregnancy test, which gives a number rather than a yes /no answer. You will then probably have a vaginal ultrasound scan to assess the pelvis. The scan will be looking for evidence of an intrauterine pregnancy and also will be looking for masses around the ovaries and fallopian tubes and fluid (blood) behind the uterus.
If a viable intrauterine (within the uterus) pregnancy is seen, it virtually excludes an ectopic pregnancy. It is very unusual to actually see an ectopic pregnancy.
With the results of the examination and investigations depending on the clinical situation and your condition, a decision will be made on your management depending on the hospital guidelines. The management options can include, in a clinically stable patient, conservative management with very close follow-up with blood pregnancy test (b-hcg) to look at the changing levels. Other managements may include use of methotrexate and subsequent close follow-up.
Diagnostic laparoscopy and laparoscopic surgery for an ectopic pregnancy would be an appropriate management in selected patients.