Ectopic Pregnancy

Question 1

True or False

Any female with vaginal bleeding, a postive hCG, and abdominal pain is an ectopic pregnancy until proven otherwise

Answer 1

TRUE

Question 2

Ectopic pregnancies occur in approximately what percent of first trimester pregnancies?

Answer 2

2%

Question 3

What are some risk factors for ectopic pregnancies?

Answer 3

History of:

1. Infertility
2. PID
3. Ruptured appendix
4. Prior tubal surgery

Question 4

What is one of the most common causes of maternal death during the first trimester?

Answer 4

Undiagnosed or undetected ectopic pregnancy

Question 5

These are all signs and symptoms of what possible condition?

1. Severe, sudden, stabbing, intermittent lower quadrant pain that doesn’t radiate
2. backache may be present
3. adnexal tenderness on exam
4. shock may occur in about 10% often after pelvic exam
5. 2/3 of patients give history of
   a. abnormal menstruations
   b. many have been infertile

Answer 5

Ectopic pregnancy

Question 6

True or False

A transvaginal ultrasound can be used to confirm an ectopic pregnancy

Answer 6

True

Question 7

What is the surgical procedure of choice to confirm and remove ectopic pregnancy?

Answer 7

Laparoscopy

Question 8

When a patient is stable with an early ectopic pregnancy, what medication can be used?

Answer 8

Methotrexate 50mg/m2 IM in single or multiple doses

Question 9

Repeat tubal pregnancies occurs about what percent of the time?

Answer 9

10%

requires early ultrasound confirmation of intrauterine pregnancy on future pregnancies