Case History: Rupture of ectopic pregnancy in fallopian tube on vaginal examination
Drs Jurkovic and Wilkinson state "Application of pressure on a
fallopian tube swollen with an ectopic pregnancy during such an
examination could potentially cause tubal rupture, although there is no
evidence for this.7".
On one occasion, I examined a patient complaining of low abdominal pain and secondary amenorrhoea. I found a left adnexal mass, and,while palpating it, felt it "pop". A few minutes later the patient collapsed and was severely hypotensive. At emergency laparotomy she was found to have a ruptured fallopian ectopic pregnancy.
My patient survived and I learnt to be very gentle when examining
patients with secondary amenorrhoea.
I agree with the authors' advice that in a suspected ectopic
pregnancy vaginal examination should be foregone and a transvaginal
ultrasound scan substituted.
Rapid Response:
Case History: Rupture of ectopic pregnancy in fallopian tube on vaginal examination
Drs Jurkovic and Wilkinson state "Application of pressure on a
fallopian tube swollen with an ectopic pregnancy during such an
examination could potentially cause tubal rupture, although there is no
evidence for this.7".
On one occasion, I examined a patient complaining of low abdominal pain and secondary amenorrhoea. I found a left adnexal mass, and,while palpating it, felt it "pop". A few minutes later the patient collapsed and was severely hypotensive. At emergency laparotomy she was found to have a ruptured fallopian ectopic pregnancy.
My patient survived and I learnt to be very gentle when examining
patients with secondary amenorrhoea.
I agree with the authors' advice that in a suspected ectopic
pregnancy vaginal examination should be foregone and a transvaginal
ultrasound scan substituted.
Competing interests: No competing interests