Ectopic Pregnancy

Question 1

define ectopic pregnancy

Answer 1

embryo grows outside of the uterus or attaches to an abnormal/scarred portion of the uterus; most commonly implants in the ampulla of the fallopian tube

Question 2

RF for ectopic pregnancy

Answer 2

• IUD use
• prev ectopic pregnancy
• Advanced maternal age
• Uterine structural abnormalities
• STI ➔ may cause damage to fallopian tubes - dysfunctional travel
• ciliary disorders - dysfunctional travel
• pelvic inflammatory disease
• smoking

Question 3

S/S of ectopic pregnancy

Answer 3

vaginal bleeding
cramping and pelvic pain
suprapubic pain
N/V
adnexa on bimanual exam - pelvic exam

Question 4

Ix for ectopic pregnancy

Answer 4

• serial b-hCG
• CBC
• group and screen and Rh type
• creatinine
• electrolytes
• bilirubin

imaging
- transvaginal u/s
- consider pelvic MRI if u/s is inconclusive/there are massive fibroids

Question 5

tx for ectopic preg

Answer 5

1. consider IM methotrexate for stable non ruptured ectopic preg
2. otherwise surgery - salpingostomy (removes inside the fallopian tube) or salpingectomy - removal of fallopian tube