| One common complication seen in early pregnancy is the presence of an ectopic pregnancy or an embryo outside of the uterus, usually in the Fallopian tubes. Ectopic pregnancy is characterized by adnexal mass and tenderness, with hypotension or other signs and symptoms of blood in the peritoneum suggesting rupture.
Risk factors for ectopic pregnancy include sexually transmitted disease, a prior ectopic pregnancy, and sometimes, prior pelvic surgery. Other risk factors include autoimmune diseases and occupational exposures. If a woman presents with pain and bleeding after an abortion, the diagnosis of ectopic pregnancy should be considered, as the products of an abortion are not always properly evacuated, and a woman may undergo the procedure without realizing that her pregnancy remains in the tubes, and has ruptured.
In an early ectopic pregnancy, medical management with methotrexate is usually adequate, but if the ectopic pregnancy ruptures or is more advanced before diagnosis, surgical treatment is necessary. |