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Ectopic Pregnancy — RACP Paediatrics MCQ

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ModerateAdolescent MedicineEctopic PregnancyRACP Paediatrics

A 15-year-old girl presents with acute right iliac fossa pain, nausea, and low-grade fever. She is sexually active. Pregnancy test is positive. Pelvic ultrasound shows an empty uterus and free fluid in the pelvis. What is the most likely diagnosis?

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Correct answer: C — Ruptured ectopic pregnancy

A positive pregnancy test with right iliac fossa pain, empty uterus on ultrasound, and free pelvic fluid in a sexually active adolescent is ruptured ectopic pregnancy until proven otherwise. This is a surgical emergency. IV access, bloods (FBC, group and screen, beta-hCG), and urgent gynaecological assessment are required. Ectopic pregnancy must always be excluded in any female of reproductive age presenting with abdominal pain.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Abdominal Pain in Adolescents