Ectopic Pregnancy
Ectopic pregnancy must be considered in any postmenarchal, sexually active adolescent with abdominal pain. It is uncommon and usually seen in late adolescence. Ectopic pregnancy occurs in 0.5-3% of all pregnancies.
Signs of ectopic pregnancy include abdominal pain in any location, vaginal bleeding, and/or amenorrhea. Nausea and vomiting, other symptoms of pregnancy, and lightheadedness may also be present.
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Abdominal, adnexal, and/or cervical tenderness are often found on pelvic examination, but occasionally abdominal tenderness is absent. The cervix may be soft (Godell’s sign) and bluish in color (Chadwick’s sign). The examination may reveal adnexal fullness and uterine enlargement. Some patients present with blood loss and hypotension or unexplained anemia. Ten percent will be in shock.
Evaluation includes a pregnancy test and ultrasound.
Treatment consists of removal of the ectopic pregnancy by laparoscopy or exploratory laparotomy.
