Pregnancy, Ectopic: Multimedia

References

1. Farquhar CM. Ectopic pregnancy. Lancet. Aug 13-19 2005;366(9485):583-91. [Medline].

2. Bouyer J, Coste J, Fernandez H, Pouly JL, Job-Spira N. Sites of ectopic pregnancy: a 10 year population-based study of 1800 cases. Hum Reprod. Dec 2002;17(12):3224-30. [Medline].

3. Saito M, Koyama T, Yaoi Y, Kumasaka T, Yazawa K. Site of ovulation and ectopic pregnancy. Acta Obstet Gynecol Scand. 1975;54(3):227-30. [Medline].

4. Nkusu Nunyalulendho D, Einterz EM. Advanced abdominal pregnancy: case report and review of 163 cases reported since 1946. Rural and Remote Health 8 (online). 2008;1087. [Full Text].

5. Goldner TE, Lawson HW, Xia Z, Atrash HK. Surveillance for ectopic pregnancy--United States, 1970-1989. MMWR CDC Surveill Summ. Dec 17 1993;42(6):73-85. [Medline].

6. Zane SB, Kieke BA Jr, Kendrick JS, Bruce C. Surveillance in a time of changing health care practices: estimating ectopic pregnancy incidence in the United States. Matern Child Health J. Dec 2002;6(4):227-36. [Medline].

7. Calderon JL, Shaheen M, Pan D, Teklehaimenot S, Robinson PL, Baker RS. Multi-cultural surveillance for ectopic pregnancy: California 1991-2000. Ethn Dis. 2005;15(4 Suppl 5):S5-20-4. [Medline].

8. Van Den Eeden SK, Shan J, Bruce C, Glasser M. Ectopic pregnancy rate and treatment utilization in a large managed care organization. Obstet Gynecol. May 2005;105(5 Pt 1):1052-7. [Medline].

9. Goyaux N, Leke R, Keita N, Thonneau P. Ectopic pregnancy in African developing countries. Acta Obstet Gynecol Scand. Apr 2003;82(4):305-12. [Medline].

10. Lewis G, ed. Saving Mothers' Lives: Reviewing maternal deaths to make motherhood safer – 2003-2005. The Seventh Report of the Confidential Enquiries into Maternal Deaths in the United Kingdom. 2007:92, 93.

11. Grimes DA. Estimation of pregnancy-related mortality risk by pregnancy outcome, United States, 1991 to 1999. Am J Obstet Gynecol. Jan 2006;194(1):92-4. [Medline].

12. Chang J, Elam-Evans LD, Berg CJ, Herndon J, Flowers L, Seed KA, et al. Pregnancy-related mortality surveillance--United States, 1991--1999. MMWR Surveill Summ. Feb 21 2003;52(2):1-8. [Medline].

13. Khan KS, Wojdyla D, Say L, Gülmezoglu AM, Van Look PF. WHO analysis of causes of maternal death: a systematic review. Lancet. Apr 1 2006;367(9516):1066-74. [Medline].

14. Bouyer J, Coste J, Shojaei T, Pouly JL, Fernandez H, Gerbaud L, et al. Risk factors for ectopic pregnancy: a comprehensive analysis based on a large case-control, population-based study in France. Am J Epidemiol. Feb 1 2003;157(3):185-94. [Medline].

15. Alsuleiman SA, Grimes EM. Ectopic pregnancy: a review of 147 cases. J Reprod Med. Feb 1982;27(2):101-6. [Medline].

16. Stovall TG, Kellerman AL, Ling FW, Buster JE. Emergency department diagnosis of ectopic pregnancy. Ann Emerg Med. Oct 1990;19(10):1098-103. [Medline].

17. Barnhart KT, Sammel MD, Gracia CR, Chittams J, Hummel AC, Shaunik A. Risk factors for ectopic pregnancy in women with symptomatic first-trimester pregnancies. Fertil Steril. Jul 2006;86(1):36-43. [Medline].

18. Kaplan BC, Dart RG, Moskos M, et al. Ectopic pregnancy: prospective study with improved diagnostic accuracy. Ann Emerg Med. Jul 1996;28(1):10-7. [Medline].

19. Anderson FW, Hogan JG, Ansbacher R. Sudden death: ectopic pregnancy mortality. Obstet Gynecol. Jun 2004;103(6):1218-23. [Medline].

20. Abbott J, Emmans LS, Lowenstein SR. Ectopic pregnancy: ten common pitfalls in diagnosis. Am J Emerg Med. Nov 1990;8(6):515-22. [Medline].

21. Dart RG, Kaplan B, Varaklis K. Predictive value of history and physical examination in patients with suspected ectopic pregnancy. Ann Emerg Med. Mar 1999;33(3):283-90. [Medline].

22. Ankum WM, Mol BW, Van der Veen F, Bossuyt PM. Risk factors for ectopic pregnancy: a meta-analysis. Fertil Steril. Jun 1996;65(6):1093-9. [Medline].

23. Strandell A, Thorburn J, Hamberger L. Risk factors for ectopic pregnancy in assisted reproduction. Fertil Steril. Feb 1999;71(2):282-6. [Medline].

24. Furlong LA. Ectopic pregnancy risk when contraception fails. A review. J Reprod Med. Nov 2002;47(11):881-5. [Medline].

25. Peterson HB, Xia Z, Hughes JM, Wilcox LS, Tylor LR, Trussell J. The risk of ectopic pregnancy after tubal sterilization. U.S. Collaborative Review of Sterilization Working Group. N Engl J Med. Mar 13 1997;336(11):762-7. [Medline].

26. Vinson DR. Emergency contraception and risk of ectopic pregnancy: is there need for extra vigilance?. Ann Emerg Med. Aug 2003;42(2):306-7. [Medline].

27. Fylstra DL. Ectopic pregnancy after hysterectomy: a review and insight into etiology and prevention. Fertil Steril. Apr 24 2009;[Medline].

28. Cohen HL, Moore WH. History of emergency ultrasound. J Ultrasound Med. Apr 2004;23(4):451-8. [Medline].

29. Gracia CR, Barnhart KT. Diagnosing ectopic pregnancy: decision analysis comparing six strategies. Obstet Gynecol. Mar 2001;97(3):464-70. [Medline].

30. Kalinski MA, Guss DA. Hemorrhagic shock from a ruptured ectopic pregnancy in a patient with a negative urine pregnancy test result. Ann Emerg Med. Jul 2002;40(1):102-5. [Medline].

31. Grynberg M, Teyssedre J, Andre C, Graesslin O. Rupture of ectopic pregnancy with negative serum beta-hCG leading to hemorrhagic shock. Obstet Gynecol. Feb 2009;113(2 Pt 2):537-9. [Medline].

32. Kohn MA, Kerr K, Malkevich D, O'Neil N, Kerr MJ, Kaplan BC. Beta-human chorionic gonadotropin levels and the likelihood of ectopic pregnancy in emergency department patients with abdominal pain or vaginal bleeding. Acad Emerg Med. Feb 2003;10(2):119-26. [Medline].

33. Marill KA, Ingmire TE, Nelson BK. Utility of a single beta HCG measurement to evaluate for absence of ectopic pregnancy. J Emerg Med. May-Jun 1999;17(3):419-26. [Medline].

34. Barnhart KT, Sammel MD, Rinaudo PF, Zhou L, Hummel AC, Guo W. Symptomatic patients with an early viable intrauterine pregnancy: HCG curves redefined. Obstet Gynecol. Jul 2004;104(1):50-5. [Medline].

35. Silva C, Sammel MD, Zhou L, Gracia C, Hummel AC, Barnhart K. Human chorionic gonadotropin profile for women with ectopic pregnancy. Obstet Gynecol. Mar 2006;107(3):605-10.

36. Dart RG, Mitterando J, Dart LM. Rate of change of serial beta-human chorionic gonadotropin values as a predictor of ectopic pregnancy in patients with indeterminate transvaginal ultrasound findings. Ann Emerg Med. Dec 1999;34(6):703-10. [Medline].

37. Mol BW, Lijmer JG, Ankum WM, van der Veen F, Bossuyt PM. The accuracy of single serum progesterone measurement in the diagnosis of ectopic pregnancy: a meta-analysis. Hum Reprod. Nov 1998;13(11):3220-7. [Medline].

38. Valley VT, Mateer JR, Aiman EJ, Thoma ME, Phelan MB. Serum progesterone and endovaginal sonography by emergency physicians in the evaluation of ectopic pregnancy. Acad Emerg Med. Apr 1998;5(4):309-13. [Medline].

39. Cabar FR, Fettback PB, Pereira PP, Zugaib M. Serum markers in the diagnosis of tubal pregnancy. Clinics (Sao Paulo). Oct 2008;63(5):701-8. [Medline].

40. DeWitt C, Abbott J. Interstitial pregnancy: a potential for misdiagnosis of ectopic pregnancy with emergency department ultrasonography. Ann Emerg Med. Jul 2002;40(1):106-9. [Medline].

41. Gun M, Mavrogiorgis M. Cervical ectopic pregnancy: a case report and literature review. Ultrasound Obstet Gynecol. Mar 2002;19(3):297-301. [Medline].

42. Dighe M, Cuevas C, Moshiri M, Dubinsky T, Dogra VS. Sonography in first trimester bleeding. J Clin Ultrasound. Jul-Aug 2008;36(6):352-66. [Medline].

43. Patel MD. "Rule out ectopic": Asking the right questions, getting the right answers. Ultrasound Q. Jun 2006;22(2):87-100. [Medline].

44. Brown DL, Doubilet PM. Transvaginal sonography for diagnosing ectopic pregnancy: positivity criteria and performance characteristics. J Ultrasound Med. Apr 1994;13(4):259-66. [Medline].

45. Stein MW, Ricci ZJ, Novak L, Roberts JH, Koenigsberg M. Sonographic comparison of the tubal ring of ectopic pregnancy with the corpus luteum. J Ultrasound Med. Jan 2004;23(1):57-62. [Medline].

46. Hertzberg BS, Kliewer MA, Bowie JD. Adnexal ring sign and hemoperitoneum caused by hemorrhagic ovarian cyst: pitfall in the sonographic diagnosis of ectopic pregnancy. AJR Am J Roentgenol. Nov 1999;173(5):1301-2. [Medline].

47. Frates MC, Brown DL, Doubilet PM, Hornstein MD. Tubal rupture in patients with ectopic pregnancy: diagnosis with transvaginal US. Radiology. Jun 1994;191(3):769-72. [Medline].

48. Blaivas M. Color doppler in the diagnosis of ectopic pregnancy in the emergency department: is there anything beyond a mass and fluid?. J Emerg Med. May 2002;22(4):379-84. [Medline].

49. Dart R, McLean SA, Dart L. Isolated fluid in the cul-de-sac: how well does it predict ectopic pregnancy?. Am J Emerg Med. Jan 2002;20(1):1-4. [Medline].

50. Nyberg DA, Laing FC, Filly RA, Uri-Simmons M, Jeffrey RB Jr. Ultrasonographic differentiation of the gestational sac of early intrauterine pregnancy from the pseudogestational sac of ectopic pregnancy. Radiology. Mar 1983;146(3):755-9. [Medline].

51. Dart RG, Dart L, Mitchell P, Berty C. The predictive value of endometrial stripe thickness in patients with suspected ectopic pregnancy who have an empty uterus at ultrasonography. Acad Emerg Med. Jun 1999;6(6):602-8. [Medline].

52. Seeber B, Sammel M, Zhou L, Hummel A, Barnhart KT. Endometrial stripe thickness and pregnancy outcome in first-trimester pregnancies with bleeding, pain or both. J Reprod Med. Sep 2007;52(9):757-61. [Medline].

53. Filhastre M, Dechaud H, Lesnik A, Taourel P. Interstitial pregnancy: role of MRI. Eur Radiol. Jan 2005;15(1):93-5. [Medline].

54. Kirk E, Condous G, Van Calster B, Van Huffel S, Timmerman D, Bourne T. Rationalizing the follow-up of pregnancies of unknown location. Hum Reprod. Jun 2007;22(6):1744-50. [Medline].

55. Mateer JR, Valley VT, Aiman EJ, Phelan MB, Thoma ME, Kefer MP. Outcome analysis of a protocol including bedside endovaginal sonography in patients at risk for ectopic pregnancy. Ann Emerg Med. Mar 1996;27(3):283-9. [Medline].

56. Burgher SW, Tandy TK, Dawdy MR. Transvaginal ultrasonography by emergency physicians decreases patient time in the emergency department. Acad Emerg Med. Aug 1998;5(8):802-7. [Medline].

57. Blaivas M, Sierzenski P, Plecque D, Lambert M. Do emergency physicians save time when locating a live intrauterine pregnancy with bedside ultrasonography?. Acad Emerg Med. Sep 2000;7(9):988-93. [Medline].

58. Adhikari S, Blaivas M, Lyon M. Diagnosis and management of ectopic pregnancy using bedside transvaginal ultrasonography in the ED: a 2-year experience. Am J Emerg Med. Jul 2007;25(6):591-6. [Medline].

59. Blaivas M, Pawl R. 269: Analysis of Lawsuits Filed Against Emergency Physicians Over Bedside Emergency Ultrasound Examination Performance or Interpretation Over a 20-Year Period. Ann Emerg Med. Sept 2007;50(3):S85.

60. Rodgerson JD, Heegaard WG, Plummer D, Hicks J, Clinton J, Sterner S. Emergency department right upper quadrant ultrasound is associated with a reduced time to diagnosis and treatment of ruptured ectopic pregnancies. Acad Emerg Med. Apr 2001;8(4):331-6. [Medline].

61. Tayal VS, Cohen H, Norton HJ. Outcome of patients with an indeterminate emergency department first-trimester pelvic ultrasound to rule out ectopic pregnancy. Acad Emerg Med. Sep 2004;11(9):912-7. [Medline].

62. Juliano M, Dabulis S, Heffner A. Characteristics of women with fetal loss in symptomatic first trimester pregnancies with documented fetal cardiac activity. Ann Emerg Med. Aug 2008;52(2):143-7. [Medline].

63. [Guideline] Practice Committee of American Society for Reproductive Medicine. Medical treatment of ectopic pregnancy. Fertil Steril. Nov 2008;90(5 Suppl):S206-12. [Medline]. [Full Text].

Further Reading

Keywords

ectopic pregnancy symptoms, ectopic pregnancy signs, ectopic pregnancy, tubal pregnancy, pregnancy-related death, pregnancy outside of the uterus, tubal infection, endometrial abnormalities, abdominal pain, pelvic pain, pelvic inflammatory disease, PID, endometriosis

Contributor Information and Disclosures

Author

Thomas J Chi, MD, Assistant Clinical Professor, Emergency Medicine, State University of New York Downstate Medical Center; Attending Physician, Emergency Medicine, Kings County Hospital Center, New York
Thomas J Chi, MD is a member of the following medical societies: American College of Emergency Physicians, American Medical Association, and Medical Society of the State of New York
Disclosure: Nothing to disclose.

Medical Editor

Assaad J Sayah, MD, Chief, Department of Emergency Medicine, Cambridge Health Alliance
Assaad J Sayah, MD is a member of the following medical societies: National Association of EMS Physicians
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Mark Zwanger, MD, MBA, Assistant Professor, Department of Emergency Medicine, Thomas Jefferson University
Mark Zwanger, MD, MBA is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and American Medical Association
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CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
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Chief Editor

Pamela L Dyne, MD, Professor of Clinical Medicine/Emergency Medicine, David Geffen School of Medicine at UCLA; Attending Physician, Department of Emergency Medicine, Olive View-UCLA Medical Center
Pamela L Dyne, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine
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