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Ectopic pregnancy is the most common cause of pregnancy-related death in the first trimester and a common diagnostoc and management challenge. Because of its relatively high incidence, ectopic preganncy rep= resents a samll but real risk of mortality from ectopic rupture. When diagnosed early, ectopic pregnancy may be treated medically rather then surgically. Therefore, ectopic pregnancy should be considered and quickly ruled out in all women of reproductive age who present with abdominal pain or vaginal bleeding. Ultrasonography remains the diagnostic test of choice, but it is less specific in patients with low beta-subunit human chorionic gonadotropin (beta-hCG levels and may not be available 2 hours a day in some hospitals and clinics. Buckley and associates reviewed and refined a previously derived clinical model for estimating the risk of ectopic pregnancy in symptomatic first0 trimester patients.
All hemodynamically stable patients of reproductive age who presented to the emergency department with abdominal pain or vaginal bleeding during the first trimester of pregnancy were enrolled in the prospective data registry. Clinical data were collected and...