Clinical Case Database / Category: Patient Management

Ectopic pregnancy - presentation and management

Publication details

Mrs Kavitha Sivakumar MBBS, DGO, DFFP, MRCOG, Mr Mike Divers BSc(Hons), MBChB, Postgrad Cert Med Ed, FRCOG
Foundation Years Journal, volume 8, issue 7, p.36 (123Doc Education, London, July 2014)


Ectopic pregnancy is a common complication of early pregnancy. Failure to consider the diagnosis in women of childbearing age can lead to misdiagnosis, substandard care and catastrophic consequences. Trans-vaginal ultrasound scan and serum ßhCG play a major role in diagnosing and managing these women. Management options include medical or surgical treatment dependent on ultrasound scan findings, serum ßhCG levels and the clinical condition of the patient.

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Mrs Kavitha Sivakumar MBBS, DGO, DFFP, MRCOG

Specialty Doctor, Obstetrics & Gynaecology
Nobles Hospital, Isle of Man, IM4 4RJ, UK

Mr Mike Divers BSc(Hons), MBChB, Postgrad Cert Med Ed, FRCOG

Consultant Obstetrician & Gynaecologist
Nobles Hospital, Isle of Man, IM4 4RJ, UK


1. Ectopic pregnancy and miscarriage: National Institute of clinical excellence NICE guideline Clinical guidelines CG154 December 2012.
2. The Management of tubal pregnancy : Royal college of obstetricians and gynaecologists RCOG green top guideline (guideline no 21) 2010.
3. Vanitha N Sivalingam, W Colin Duncan, Emma Kirk,Lucy A Shephard, and Andrew W HorneDiagnosis and management of ectopic pregnancy J FamPlannReprod Health Care. Oct 2011; 37(4): 231–240.
4. Dart RG1, Kaplan B, Varaklis K. Predictive value of history and physical examination in patients with suspected ectopic pregnancy Ann Emerg Med. 1999 Mar;33(3):283-90.
5. Crochet JR1, Bastian LA, Chireau MV Does this woman have an ectopic pregnancy?: the rational clinical examination systematic review. JAMA. 2013 Apr 24;309(16):1722-9. doi: 10.1001/ jama.2013.3914. (Pubmed).
6. Zee J1, Sammel MD, Chung K, Takacs P, Bourne T, Barnhart KT Ectopic pregnancy prediction in women with a pregnancy of unknown location: data beyond 48 h are necessary HumReprod. 2014 Mar;29(3):441-7. doi: 10.1093/humrep/det450. Epub 2013 Dec 18.(Pubmed).
7. Kirk E, Bottomley C, Bourne T. Diagnosing ectopic pregnancy and current concepts in the
management of pregnancy of unknown locationHumReprod Update. 2014 Mar-Apr;20(2):250-61. doi: 10.1093/humupd/dmt047. Epub 2013 Oct 6. (Pubmed).
8. Kirk E, Daemen A, Papageorghiou AT, Bottomley C, Condous G, De Moor B, Timmerman D,
Bourne T Why are some ectopic pregnancies characterized as pregnancies of unknown location at the initial transvaginal ultrasound examination? ActaObstetGynecol Scand. 2008;87(11):1150-4. doi: 10.1080/00016340802443822.
9. Lucie Morin, Michiel C. Van den Hof et al. Ultrasound Evaluation of First Trimester Pregnancy Complications J ObstetGynaecol Can 2005;27(6):581–585.
10. Sagili H, Mohamed K. Pregnancy of unknown location: an evidence-based approach to management. The Obstetrician &Gynaecologist 2008;10:224–230.
11. Barnhart K, van Mello NM, Bourne T, Kirk E Pregnancy of unknown location:a consensus statement of nomenclature, definitions, and outcome. FertilSteril. 2011 Mar 1;95(3):857-66.
12. Nick Raine-Fenning,ShyamalySur , Andrew W Horne ,Helen Wilkinson , Tom Bourne. Pregnancy of unknown viability or location: less is more in the majority of cases J FamPlannReprod Health Care 2012;38:7-10.
13. The eighth report of Confidential enquiries into maternal death in UK 2009-2011


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T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

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