Ectopic pregnancy

Ectopic pregnancy occurs in approximately 2% of all pregnancies in the Unit ed States, and is the nation's leading cause of first trimester maternal de ath. Its incidence has increased sixfold in the past 25 years, despite sign ificant improvements in techniques for early diagnosis and management. This article reviews the epidemiology, risk factors, and common clinical presen tations of ectopic pregnancy. Both traditional and newly developed strategi es for diagnosis and management are described. The primary care physician i s in an excellent position to screen for and diagnose ectopic pregnancy, an d to counsel patients regarding treatment options and future risks. With th e increasing trend toward outpatient nonsurgical management of ectopics, it is expected that the roll of the primary care physician in managing patien ts with ectopic pregnancy will continue to increase.