Ectopic pregnancy occurs when the blastocyst implants outside the uterine cavity; 97% of cases occur in a fallopian tube (tubal pregnancy).
Presentation and clinical features of Ectopic pregnancy .
Although more than 90% of patients with tubal pregnancies have abdominal or pelvic pain, some may be asymptomatic. Early (unruptured) ectopic pregnancies often present with amenorrhea, vaginal spotting, and colicky, vague lower abdominal pain, whereas patients with ruptured ectopic pregnancies often present with severe pain, syncope, and dizziness. Pleuritic chest pain and shoulder pain from diaphragmatic irritation by blood can also occur.
Physical examination of Ectopic pregnancy
Vital signs vary greatly, from normal blood pressure and pulse to hypotension and tachycardia due to cardiovascular collapse secondary to hemorrhage. Whereas patients with unruptured ectopic pregnancy may demonstrate only mild tenderness, peritoneal signs including marked tenderness, rigidity, guarding, and rebound may also be found. Pelvic masses sometimes are palpable, but lack of a mass does not exclude ectopic pregnancy. The uterus may appear small for presumed gestational date.