ECTOPIC

Question 1

leading signs

Answer 1

abdominal pain and bleeding always be suspicious

Question 2

rf

Answer 2

main prior STD, endometriosis, IVF, prior ectopic

Question 3

phsyical exam

Answer 3

may be able to feel a mass

Question 4

for you to confirm a prgenancy what should you see on US

Answer 4

gestational sac and yok sac- 1 isnt enough and embryo which should be visable by 5-6 weeks

Question 5

surgical indications

Answer 5

significant pain
large adnexal mass
high b-hcg levels
us shows a fetal heart beat

Question 6

diagnosis

Answer 6

+ pregnancy test but lower than expected

Question 7

treatment conservative

Answer 7

Medical management involves a one-off dose of methotrexate.

This is often the first-line management for women unless there are any of the indications for surgical management as listed below.

The woman is required to come to a follow-up appointment.

If the initial dose of methotrexate has failed to treat the ectopic they will require either a second dose of methotrexate or surgical management.

Question 8

surgical otpions quesmed

Answer 8

Surgical management is often in the form of a salpingectomy where the Fallopian tube containing the ectopic is removed. In cases where the ectopic is in a woman with only one functioning Fallopian tube, and they wish to remain fertile, a salpingotomy may be done where only the ectopic is removed.

Salpingotomy carries the risk that not all the tissue may have been removed and so serial serum B-hCG measurements are done to exclude any trophoblastic tissue still within the Fallopian tube.

Question 9

whats an interstital pregancy and what do you do to tx

Answer 9

An interstitial pregnancy is a uterine but ectopic pregnancy; the pregnancy is located outside the uterine cavity in that part of the fallopian tube that penetrates the muscular layer of the uterus.

Cornual resection: performed when interstitial pregnancy occurs; wedge resection
of interstitial portion performed