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Chapter 21 - Diagnosis and Management of Extrauterine Pregnancies

Published online by Cambridge University Press:  16 April 2025

By
Lucrezia de Braud  and
Davor Jurkovic
Edited by
Roy G. Farquharson ,
Mary D. Stephenson  and
Mariëtte Goddijn
Roy G. Farquharson
Affiliation:
Liverpool Women’s Hospital
Mary D. Stephenson
Affiliation:
University of Illinois, Chicago
Mariëtte Goddijn
Affiliation:
Amsterdam University Medical Centers
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Summary

Extrauterine ectopic pregnancies includes tubal (ampullary, isthmic and interstital), ovarian, abdominal and rudimentary horn ectopic pregnancies. Most clinicians are familiar with ampullary or isthmic tubal ectopics, as these represent the majority of extrauterine ectopic. However, it is important to be aware of the other types, as, if not recognised promptly, these can lead to an even higher morbidity and mortality for women compared to tubal ectopics.

The diagnostic gold standard is transvaginal ultrasound, and the key to successful diagnosis is careful examination of all potential sites of ectopic pregnancy implantation. Specific characteristics, such as the sliding sign, which consisnt in appling gentle pressure with the ultrasound probe combined with abdominal palpation to demonstrate free move

ment between the adnexal mass and the ovary, can help differentiate a tubal ectopic from an ovarian or abdominal ectopic pregnancy, while the presence of a unicornuate uterus should raise the suspicions of a rudimentary horn pregnancy. Also their clinical presentation varies, and the management strategy, including expectant, medical and surgical management, should be tailored on the pregnancy location, viability and patient clinical condition.

Keywords

Ectopic pregnancyTubal ectopicInterstitial ectopicOvarian ectopicAbdominal ectopicRudimentary horn ectopicHeterotopic pregnancyTransvaginal ultrasound
Type
Chapter
Information
Early Pregnancy , pp. 213 - 228
Publisher: Cambridge University Press
Print publication year: 2025

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