Ruptured ectopic pregnancy

Ruptured ectopic pregnancy

Clinical presentation

• History of amenorrhoea

• Acute generalized abdominopelvic pain

• Hypotension

• Fast and weak pulse

• Abdominal distension and tenderness with rebound tenderness

Management of ruptured ectopic pregnancy at the dispensary and health centre (BEmONC facilities)

• Apply Airway, Breathing, Circulation and Dehydration (ABCD) principles of resuscitation

• Perform abdominal and pelvic ultrasound if available

• Check haemoglobin level

• Start compound sodium lactate (IV) or 0.9% sodium chloride (IV) at an infusion rate of 500 mL per hour

Referral

• Ectopic pregnancy is an obstetric emergency. Resuscitate and refer the patient immediately with an escort by a skilled attendant

Management of ectopic pregnancy at the hospital (CEmONC facilities)

Investigations

• Perform abdominal, pelvic, or transvaginal ultrasonography

• Check haemoglobin level

• Perform blood grouping and cross-matching

Management

• Give compound sodium lactate (IV) or 0.9% sodium chloride (IV), depending on the amount of blood loss

• Give blood transfusion if indicated, depending on the amount of blood loss

• Perform emergency laparotomy.