Ectopic and molar pregnancy Flashcards
What is an ectopic pregnancy?
Pregnancy implanted outside of endometrial cavity
Where is the most common location for an ectopic?
Ampulla of fallopian tube
Where can an ectopic implant?
Fallopian tube Ovary Cervix Myometrium C section scar Abdomen
What are the risk factors for an ectopic?
Previous ectopic Previous tubal surgery PID Assisted conception IUD
What is the presentation of an ectopic?
Period of amenorrhoea, + pregnancy test, but empty endometrial cavity
Rupture
What is the presentation of a ruptured ectopic?
PV bleeding
Pelvic and abode pain and tenderness
Shoulder tip pain
Symptoms of blood loss
How is an ectopic diagnosed?
Urine pregnancy test
Serum BhCG- elevated but static
US
Serum progesterone- elevated
What is seen on an US with an ectopic?
No intrauterine gestational sec
Free fluid in pouch of Douglas
Thickened endometrium
What is the management of an ectopic in an unstable patient?
Surgery
- salpingectomy in most cases
- salpingostomy if other tube removed
What is the management of an ectopic in a stable patient with a small mass?
Methotrexate
What are the complications of an ectopic?
Rupture
Recurrent ectopic pregnancy
Persistent trophoblast
What is a molar pregnancy?
Non viable fertilised egg implants in endometrium and fails to develop
What is the presentation of a molar pregnancy?
Painless PV bleeding in 1st or early 2nd trimester
Large for dates uterus
Exaggerated symptoms of pregnancy
What investigations are done for a molar pregnancy?
Serum hCG- very high
US- large for dates uterus, no foetus
What is the management of a molar pregnancy?
Uterine suction
Dilatation and curettage
