Ectopic Pregnancy

Question 1

Ectopic pregnancy

Answer 1

Implantation of pregnancy elsewhere out of the uterine cavity

Question 2

Most common sites of ectopic pregnancy

Answer 2

Ampulla
Vagina
Abdominal
Ovarian

Question 3

Causes of ectopic pregnancy

Answer 3

PID
Previous hx
Pelvic Hx
IUD

Question 4

Features of ectopic pregnancy

Answer 4

N/V
Amenorrhea
Lower abdominal pain

Question 4

Features of ectopic pregnancy

Answer 4

N/V
Amenorrhea
Lower abdominal pain

Question 5

Gold standard test for dx of Ectopic pregnancy

Answer 5

TVUSS (Empty gestational sac, free fluid and adnexal mass)
Laparoscopy (Gold)

Question 6

Lower abdominal pain D/Ds

Answer 6

Ovarian torsion
PID
UTI
Appendicitis
DR. MAT (diverticulitis, ruptured corpus luteum, molar pregnancy, appendicitis, threatened abortion)

Question 7

Why is shoulder tip pain happening in Ectopic pregnancy?

Answer 7

Ectopic rupture → bleeding → diaphragm irritated → phrenic nerve stimulated

Question 8

Ectopic rupture

Answer 8

Shoulder tip pain
Cervical excitation

Question 9

B-HCG levels

Answer 9

> 2000 IU/L

Question 10

Management of Ectopic Pregnancy

Answer 10

Medical Management
Surgical Management

Question 11

When medical management should be given?

Answer 11

Stable
>3000 IU/L
<4cm
No FHR
Live close to the hospital

Question 12

What is medical management?

Answer 12

MTX (Repeat HCG 24 hours should decrease by 15%)

Question 13

MTX side effects

Answer 13

Conjunctivitis
Stomatitis
Gastroenteritis

Question 14

MTX follow up

Answer 14

Dont have intercourse
Dont conceive for 3 months after MTX therapy

Question 15

Surgical Management

Answer 15

Tubal Ligation to prevent rupture
Unstable → Laparotomy and Salpingectomy
Stable → Laparoscopy and Salpingectomy
Stable → Salpingotomy (if one fallopian tube)