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Embarazo ectópico

Last reviewed: 15 Jul 2025
Last updated: 14 Aug 2024

Summary

Definition

History and exam

Key diagnostic factors

  • dolor abdominal
  • amenorrea
  • sangrado vaginal
  • abdomen doloroso a la palpación
  • dolor anexial a la palpación o masa
  • sangre en la cúpula vaginal
  • inestabilidad hemodinámica, hipotensión ortostática
  • dolor al movimiento cervical
Full details

Other diagnostic factors

  • necesidad imperiosa de defecar
  • dolor referido de hombro
Full details

Risk factors

  • embarazo ectópico previo
  • cirugía de esterilización tubárica previa
  • exposición al dietilestilbestrol en el útero de la madre
  • uso de un dispositivo intrauterino (DIU)
  • infecciones genitales previas
  • salpingitis crónica
  • salpingitis ístmica nodosa
  • infertilidad
  • múltiples parejas sexuales
  • tabaquismo
  • raza/etnia
  • tecnología de reproducción asistida (TRA)
  • primer encuentro sexual <18 años
  • edad materna >35 años
  • cirugía de reconstrucción tubárica
Full details

Diagnostic tests

1st tests to order

  • prueba de embarazo en orina o suero
  • ETV de alta resolución
  • ecografía de abdomen
Full details

Tests to consider

  • gonadotropina coriónica humana (hCG) en suero
  • aspiración uterina
Full details

Treatment algorithm

ACUTE

embarazo ectópico tubárico: rotura de embarazo ectópico o fallo del manejo médico

embarazo ectópico tubárico: riesgo moderado o fracaso del manejo expectante

embarazo ectópico tubárico: bajo riesgo

Contributors

Authors

Kurt T. Barnhart, MD, MSCE

William Shippen Jr. Professor of Obstetrics and Gynecology and Epidemiology

Vice Chair for Clinical Research

Director, Women's Health Clinic Research Center

The Perelman School of Medicine

University of Pennsylvania

Associate Chief, Penn Fertility Care

Philadelphia

PA

Disclosures

KTB is a co-author on several papers cited in this topic.

Acknowledgements

Dr Kurt T. Barnhart would like to gratefully acknowledge Dr Ingrid Granne, Dr Veronica Gomez-Lobo, Dr Sina Haeri, and Dr Mohammad Ezzati, previous contributors to this topic.

Disclosures

IG, VGL, SH, and ME declare that they have no competing interests.

Peer reviewers

Alan Decherney, MD

Chief

Reproductive Biology Medicine and Biology

NICHD

Bethesda

MD

Disclosures

AD declares that he has no competing interests.

Joanna C. Girling, MA, MRCP, FRCOG

Consultant in Obstetrics and Gynaecology

West Middlesex University Hospital

London

UK

Disclosures

JCG declares that she has no competing interests.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

ACOG practice bulletin no. 193: tubal ectopic pregnancy. Obstet Gynecol. 2018 Mar;131(3):e91-103. Abstract

Kirk E, Bottomley C, Bourne T. Diagnosing ectopic pregnancy and current concepts in the management of pregnancy of unknown location. Hum Reprod Update. 2014 Mar-Apr;20(2):250-61.Full text  Abstract

Elson CJ, Salim R, Potdar N, et al; Royal College of Obstetricians and Gynaecologists. Diagnosis and management of ectopic pregnancy: Green-top Guideline No. 21. BJOG. 2016 Dec;123(13):e15-55.Full text  Abstract

National Institute for Health and Care Excellence. Ectopic pregnancy and miscarriage: diagnosis and initial management. Nov 2021 [internet publication].Full text

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Embarazo ectópico images
  • Differentials

    • Aborto espontáneo
    • Apendicitis aguda
    • Torsión ovárica
    More Differentials
  • Guidelines

    • Ectopic pregnancy and miscarriage: diagnosis and initial management
    • ACR appropriateness criteria: acute pelvic pain in the reproductive age group
    More Guidelines
  • Patient information

    Embarazo ectópico: ¿qué tratamientos funcionan?

    More Patient information
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