Ectopic pregnancy

Question 1

Do youe xamine for an adnexal mass

Answer 1

No, risk of rupturing ectopic

Question 2

Cervical examination

Answer 2

tenderness

Question 3

97% are tubal, with most in

Answer 3

ampulla

Question 4

More likely to rupture if in

Answer 4

isthmus

Question 5

RFs

Answer 5

PID
Endometriosis
IUCD
IVF

Question 6

Investigations for EP

Answer 6

Pregnancy test
TVUSS

Question 7

Size <35mm
Unruptured
Asymptomatic
No fetal heartbeat
hCG <1,000IU/L

Answer 7

Expectant management

Question 8

Size <35mm
Unruptured
No significant pain
No fetal heartbeat
hCG <1,500IU/L

Answer 8

Medical management

Question 9

Size >35mm
Can be ruptured
Pain
Visible fetal heartbeat
hCG >5,000IU/L

Answer 9

Surgical management

Question 10

Expectant management

Answer 10

closely monitoring the patient over 48 hours and if B-hCG levels rise again or symptoms manifest intervention is performed.

Question 11

Medical management

Answer 11

giving the patient methotrexate and can only be done if the patient is willing to attend follow-up.

Question 12

Surgica management

Answer 12

Salpingectomy is first-line (no other risk factor for infertility)

Salpingotomy should be considered for women with risk factors for infertility such as contralateral tube damage