Ectopic pregnancy should be suspected if a woman of fertile age has lower abdominal pain and irregular vaginal bleeding. Symptoms range from almost none to shock.
The diagnosis is based on a quantitative serum pregnancy test (hCG) and transvaginal ultrasound.
An acute situation requires emergency surgery, whereas patients with mild symptoms should be treated policlinically by follow-up or a single intramuscular dose (1mg/kg) of methotrexate. No folic acid supplementation is needed. In later pregnancies their location should be verified by transvaginal ultrasound done by the seventh gestational week at the latest.
Juha Mäkinen (Chair)