Ectopic pregnancy Flashcards
What is an ectopic pregnancy?
Pregnancy implanted outside the uterus
1) Where does it most commonly occur?
2) Name another location it can occur in
1) Fallopian tubes
2) Entrance to the fallopian tube (cornual region), ovary, cervix or abdomen
Name 3 risk factors for an ectopic pregnancy
- Previous ectopic pregnancy
- Previous pelvic inflammatory disease
- Previous surgery to the fallopian tubes
- Intrauterine devices (coils)
- Older age
- Smoking
1) At what stage of gestation does ectopic pregnancy normally present?
2) Name 2 ways it can present
3) Why should you ask about shoulder pain and dizziness?
1) 6-8 weeks
2) Missed period, constant lower abdominal pain in the right or left iliac fossa, vaginal bleeding, lower abdominal or pelvic tenderness, cervical motion tenderness (pain when moving the cervix during a bimanual examination)
3) Shoulder pain - peritonitis, dizziness - blood loss
1) What is the investigation of choice for ectopic pregnancy?
2) How can you differentiate between a mass representing a tubal ectopic pregnancy and a corpus luteum in an ultrasound?
1) Transvaginal ultrasound scan
2) A tubal ectopic pregnancy moves separately to the ovary, whereas a corpus luteum will move with the ovary
All ectopic pregnancies need to be terminated.
1) In expectant management, what happens?
2) In medical management, what is given?
3) In surgical management, what is done, and what are these 2 procedures?
1) Wait for termination to occur naturally
2) Methotrexate
3) Salpingectomy (fallopian tube excision - 1st line treatment) or salpingotomy (incision into a Fallopian tube to remove an ectopic) [most common]
Name 2 side effects of using methotrexate as the medical management of ectopic pregnancy
- Vaginal bleeding
- Nausea and vomiting
- Abdominal pain
- Stomatitis (inflammation of the mouth)
- Having to avoid pregnancy for at least 3 months after due to the teratogenic nature of methotrexate
