The vibration during a helicopter ride or the jostling over rough roads in an ambulance or truck may provoke the actual rupture. Try to minimize this risk and be prepared with IV fluids, oxygen, MAST equipment, etc. Ruptured Ectopic Pregnancy Women with a ruptured ectopic pregnancy will nearly always have pain, sometimes unilateral and sometimes diffuse. Right shoulder pain suggests substantial blood loss. Serum pregnancy tests are positive.
Treatment is immediate surgery to stop the bleeding.
If surgery is not an available option, stabilization and medical evacuation should be promptly arranged. Give oxygen, IV fluids and blood according to ATLS guidelines. Keep the patient at absolute rest. Monitor urine output hourly with a Foley catheter and take frequent vital signs to detect shock. Consider MAST trousers.