Ectopic Pregnancy

Question 1

Rate of diagnosis of ectopic pregnancy is increased dt ..?

Answer 1

Use of B hcg and us in diagnose of pregnancy
Use of laporascopy in diagnosis and management of doubtful cases of pelvic and adnexal pain
Introduction of ARS In the management of infertility
Increased incidence of PID and STDs

Question 2

Leading cause of maternal mortality in ectopic pregnancy is …… And accounts for….of all pregnancy related death

Answer 2

1- Hemorrhage
2- 4to10%

Question 3

What are the predisposing factors of tubal ectopic pregnancy ?

Answer 3

Previous ectopic:15% rish of recurrence
Dt underlying tubal disorder and the choice of ttt procedure
Salpingitis : that alter the tubal function and causes tubal obstruction & PID
Surgery
Tubal ligation, re-anastomosis tuboplasty

Stretch broad ligament myomas, cysts
Peritubal adhesion: PID , endometriosis, surgery
Gynecological: ovarian cystectomy myomectomy
Pelvic : appendectomy
Congenital anomalies history of diethylstilbestrol exposure
Iatrogenic: ART==> fertility drugs and IVF
Infertility: dt increase incidence of tubal abnormalities in this group of patients
Use of fertility drugs

Question 4

What are the pathological changes occurring in undisturbed tubal pregnancy

Answer 4

Tube
1)decidual reaction is poor and 2) ovum penetrates deeply into muscle layer
3) trophoblast secretes HCG
Ovary
Hcg secreted from the ovum causes formaton of corpus luteum of pregnancy that secretes estrogen and progesterone
Uterus
The uterus is symmetrically enlarged and soft only hormonal enlargement
Endometrium shows decidual reaction without trophoblast arias Stella reaction