Ectopic Pregnancy

Demographics

ASME
 26 years old
 G4P3(3003)
 Sangali, ZC

 CC: vaginal bleeding

History of Present Illness

 4 days ptc,noted on and off hypogastric pain,no bleeding, no consult

done.
 3 days ptc, persistence of symptom, prompted patient to go to hilot,
was told pregnant, still no consult.
 1 night ptc, noted hypogastric pain associated with vaginal bleeding,
no pads used, no consult done.
 (-) passage of meaty tissue (-) dysuria
 Persistence of symptoms prompted consult.
History

 Past medical history: no comorbidities, no previous admissions or surgeries reported, PT

or UTZ not done
 Family history: no known heredofamilial diseases
 Personal and Social History: non-smoker, non-alcoholic beverage drinker
Physical Exam

VS
 BP 90/60 mmhg
 PR 105 bpm
 RR 22 cpm
 T 36.6 C
 Ht 149 cm
 Wgt 46 kg (prepregnancy)
 BMI 20.72
Physical Exam

 Awake, NIRD
 AS, Pale PC, (-) CLAD
 ECE, CBS
 AP, NRRR, no heart murmurs
 Flabby abdomen, soft, (+) tender hypogastric area
 Good pulses, (-)edema
Internal Examination

 NEG
 cervix closed, 2x2cm
 (-) cervical motion tenderness
 corpus small
 (+) left adnexa tenderness
 (-) mass, BPSP
 (+) blood on examining finger
Ultrasound

 Ruptured ectopic pregnancy

 Noted 8 x 4 cm complex mass superior to the uterus
 Thin EM with hematometra
 Massive hemoperitoneum
Admitting Impression

Acute Surgical Abdomen secondary to

Ruptured Ectopic Pregnancy, 9 3/7 weeks
age of gestation, G4P3(3003)