Diagnosis

Anamnesis and clinical symptoms History of late menstruation,

symptoms and signs of a young pregnancy, there can be or no
bleeding per vaginam, there is abdominal pain right / left down.
The weight or severity of the pain depends on the amount of blood
collected in the peritoneum.
Physical examination
- Getting a uterus that also enlarged, the tumor in the adnexa area.
- The presence of signs of hypovolemic shock, namely
hypotension, pale and cold extremities, the presence of acute
abdominal signs, namely lower abdominal stomach, tenderness
and pain loose abdominal wall.
 Diagnosis
• Gynecological examination Examination in: soft palpable strike,
tenderness, pain in right and left uteris. Supporting investigation
Laboratory: Hb, Leukocytes, urine B-hCG (+). Hemoglobin decreases
after 24 hours and the number of red blood cells may increase.
Ultrasound:
• There is no gestational sac in the uterine cavity
• The presence of a pregnancy sac outside the uterine cavity
• The existence of a complex mass in the pelvic cavity
• Kuldocentesis: a way of checking to see if there is blood in the
Douglas cavity. The definitive diagnosis is only confirmed by
laparotomy. Ultrasound is useful in 5 - 10% of cases when a
gestational sac is found outside the uterus (Mansjoer, et al, 2001).
 Differential diagnosis
- pelvic infection
- Abortus iminens or insipiens
- Torque ovarian cysts
- Rupture of the corpus luteum
- Acute Appendicitis (Wibowo, 2007;
Cunningham et al, 2005).