Ectopic pregnancy

Question 1

Name two common causes of severe right lower abdominal pain
other than ectopic pregnancy.

Answer 1

Acute appendicitis, ovarian cyst disease, renal colic.

Question 2

Name two symptoms or signs that m ay make ectopic pregnancy
more likely.

Answer 2

Amenorrhoea, vaginal bleeding, tachycardia, hypotension,
shoulder tip pain, cervical excitation, adnexal mass.

Question 3

W h a t bedside investigation m ay help the diagnosis?

Answer 3

Urine ßhCG.

Question 4

W hat investigation is
indicated in a haemodynamically stable patient

Answer 4

Transabdominal and transvaginal ultrasound scanning.

Question 5

Name two factors predisposing to ectopic pregnancy.

Answer 5

Previous pelvic inflammatory diease (e.g. chlamydia), previous
tubal surgery, previous ectopic pregnancy, endometriosis,
progesterone-only pill, presence of intrauterine contraceptive
device, previous sterilisation.

Question 6

Name two sites w here a fertilised ovum may implant.

Answer 6

Fallopian tube, ovary, cervix, peritoneum, liver.

Question 7

Investigations reveal an 8-w eek gestational sac in the rig h t
Fallopian tube. H o w could this patient be managed surgically?

Answer 7

Laparotomy/laparoscopy with salpingectomy or salpingostomy.

Question 8

H o w could this case be managed medically, provided ectopic is
small with minimal symptom s?

Answer 8

IM methotrexate

Question 9

rhesus negative management

Answer 9

Injection of anti-D immunoglobulin.