19- Ectopic Pregnancy

Question 1

mutifetal pregnancy with one conceptus with norma uterine implantation coexisting with one implanted ectopically

Answer 1

Heterotropic pregnancy p.377

Question 2

Confers highest risk for an ectopic pregnancy

Answer 2

Previous surgery p. 377

Question 3

Percent chance of an ectopic after 1 previous ectopic?

Answer 3

10% p.377

Question 4

Risk factors for tubal pregnancy

Answer 4

(1) previous surgery (2) tubal pathology (3) STD due to distoration of normal tubal anatomy (4) appendicitis (5) endometriosis (6) IUD which slows fallopian tube movement (7) multiple partners (8) smoking (9) douching

Question 5

The fallopian tube lacks _______ , causing the fertilized ovum to promptly burrow through the epithelium

Answer 5

Submucosal layer p 378

Question 6

Outcomes of tubal pregnancy?

Answer 6

(1) tubal rupture (2) tubal abortion (3) pregnancy failure with resolution p.378

Question 7

(1) Most frequent site (2) rupture at 8-12 weeks

Answer 7

Ampulla (70%) p. 378

Question 8

(1) Second most common site (2) Almost always result to rupture at 6-8 weeks/ first few weeks

Answer 8

Isthmus p. 378

Question 9

If the fimbriated end of the fallopian tube is occluded, it can can become distended forming a

Answer 9

Hematosalpinx p.379

Question 10

True or false: Most ectopic pregnancies will spontaneoously resolve

Answer 10

True. 60% will resolve on its own

Question 11

Classic triad of Ectopic Pregnancy?

Answer 11

(1) delayed menstruation (2) pain (3) vaginal bleeding or spotting

Question 12

More valuable index of blood loss (a) initial or (b) after several hours?

Answer 12

(b) after several hours- the initial reading may only reveal a slight reduction in acute hemorrhage