A potentially fatal but easily missed condition
There were 32 100 ectopic pregnancies in the United Kingdom between 2003 and 2005, an incidence of 11.0 per 1000 pregnancies. Ten of these ectopic pregnancies resulted in maternal death, through a process of rupture and haemorrhage.1 Women who present late may already have signs of hypovolaemic shock, but in the early stages the symptoms can be subtle, making this a condition that may be missed in 40% to 50% of patients at an initial visit.2 Correct early diagnosis not only saves lives but also reduces morbidity and enables more chance of preserving future reproductive capacity.3 An ability to correctly identify the initial signs of an early ectopic pregnancy is therefore an important aspect of acute medicine relevant not only to the obstetrics and gynaecology trainee but also to general practitioners, emergency department staff, physicians, and general surgeons.
An ectopic pregnancy is a pregnancy that is not in the uterus. Most