Summary

• Typically presents 6-8 weeks after last normal menstrual period, but can present later.
• Risk increases with prior ectopic pregnancy, tubal surgery, genital infections, smoking, or IUD usage.
• Classical symptoms and signs are pain, vaginal bleeding, and amenorrhoea. Haemodynamic instability and cervical motion tenderness may indicate rupture or imminent rupture.
• If the patient is haemodynamically stable, transvaginal ultrasound is the initial test of choice.
• Treatment approaches include expectant, medical (methotrexate), or surgical (salpingectomy, salpingostomy).
• Can be complicated by rupture, in which case may present in shock from blood loss and with unusual patterns of referred pain from intraperitoneal blood.