Ectopic Pregnancy

Question 1

Any female with vaginal bleeding, positive hCG and abdominal pain is WHAT until proven otherwise.

Answer 1

Ectopic Pregnancy

Question 2

Ectopic Pregnancy Occurs in approximately __% of first trimester pregnancies.

Answer 2

2%

Question 3

Risk factors for Ectopic Pregnancy include history of

Answer 3

(a) Infertility,
(b) Pelvic inflammatory disease,
(c) Ruptured appendix,
(d) 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

S/s of what issue?
(1) Severe lower quadrant pain
–(b) Sudden in onset,
–(c) Stabbing
–(d) Intermittent
–(e) Does not radiate
(2) Backache may be present during attacks.
(3) Adnexal tenderness on physical exam.
(4) Shock may occur in about 10%, often after pelvic examination
(5) At least two-thirds of patients give a history of
–(a) Abnormal menstruation;
–(b) Many have been infertile

Answer 5

Ectopic

Question 6

Imaging for Ectopic pregnancy

Answer 6

Transvaginal Ultrasound

Question 7

True/False
When patient is stable with an early ectopic, medication can be used

Answer 7

True

Question 8

Disposition for Ectopic Pregnancy

Answer 8

MEDIVAC
Refer to Obstetrics

Question 9

Tx for Ectopic pregnancy

Answer 9

Surgical
-Laparoscopy When patient is unstable or rupture has occurred
Meds
-Methotrexate 50mg/m2 IM in single or multiple doses
(Stops cells from growing ending pregnancy)

Question 10

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

Answer 10

Laparoscopy

Question 11

Repeat tubal pregnancy occurs in __% of cases

Answer 11

10%

Question 12

True/False
Patients with Hx of Ectopic Pregnancy requires early ultrasound confirmation of intrauterine pregnancy on future pregnancies.

Answer 12

True

Question 13

Any patient suspected of ectopic pregnancy should be emergently referred to WHERE?

Answer 13

Obstetrics