RLQ Pain, LLQ Pain

• Most common location of ectopic pregnancy: Ampulla of fallopian tube (A) - (80%)
• G → cornul ectopic (2%)
• Abdominal (1.5%)
• Cervical (2%)

DDx:

• Can be ruptured !Ruptured Ovarian cyst if bHCG is negative and Hb is low

Presentation

History of not getting period + abdominal pain

Adnexal pain (RLQ or LLQ)

• Adnexa: the area adjacent to the uterus, including the ovaries, fallopian tubes, and surrounding connective tissues

Shoulder tip pain

• if the diaphragm gets irritated → will refer to shoulder

Physical Exam

<aside> 💡

• In patients with ectopic pregnancy, don’t do cervical motion tenderness exam (or any internal exam)
  • Risk of rupture tubal ectopic pregnancy
  • Don’t do pelvic exam UNLESS seeing fever or any inflammatory signs </aside>

Signs of Pregnancy

• SFH - Symphysis Fundal Height increasing
• Cervical cynosis (Chadwick Sign)
• Uterus-cervical junction & cervix Softening

Retro-peritoneal Hemorrhage (ruptured)

• Cullen’s sign , Rebound tenderness

Prognosis