Diagnosis and Management of Ectopic Pregnancy (Green-top Guideline No. 21)

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Diagnosis and management of ectopic pregnancy RCOG Joint with the Association of Early Pregnancy Units

An ectopic pregnancy is any pregnancy implanted outside of the endometrial cavity. In the UK, the incidence is approximately 11/1000 pregnancies, with an estimated 11 000 ectopic pregnancies diagnosed each year. This guideline will cover the following ectopic pregnancies: tubal, cervical, caesarean scar, interstitial, cornual, ovarian, abdominal and heterotopic. The diagnosis and management of pregnancy of unknown location will not be covered.

Unfortunately, women still die from ectopic pregnancy, with six maternal deaths reported between 2006 and 2008. However, the case fatality rate has decreased over recent years, suggesting that earlier diagnosis and treatment may have made an impact.

Risk factors for ectopic pregnancy include tubal damage following surgery or infection, smoking and in vitro fertilisation. However, the majority of women with an ectopic pregnancy have no identifiable risk factor.

This guideline replaces The Management of Tubal Pregnancy, which was published in 2004.

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