Ectopic pregnancy Flashcards
What is an ectopic pregnancy?
Implantation of a fertilized ovum outside the uterus.
What is a typical history of a female presenting with ectopic pregnancy?
A female with a history of 6-8 weeks amenorrhoea who presents with lower abdominal pain and later develops vaginal bleeding.
What are the common symptoms of ectopic pregnancy?
Lower abdominal pain, vaginal bleeding, dizziness, fainting, and symptoms of pregnancy such as breast tenderness.
What is the typical nature of lower abdominal pain in ectopic pregnancy?
Pain is usually constant, may be unilateral, and is due to tubal spasm.
What is the typical appearance of vaginal bleeding in ectopic pregnancy?
Usually less than a normal period and may be dark brown in colour.
What examination findings are associated with ectopic pregnancy?
Abdominal tenderness, cervical excitation, and possible adnexal mass. A pelvic examination is recommended, but examination for an adnexal mass is not advised.
What does a serum bHCG level >1,500 indicate in the case of pregnancy of unknown location?
It points toward a diagnosis of an ectopic pregnancy.
What is the incidence of ectopic pregnancy?
Approximately 0.5% of all pregnancies.
What are some risk factors for ectopic pregnancy?
Damage to tubes, previous ectopic, endometriosis, IUCD, progesterone only pill, and IVF.
How is ectopic pregnancy typically investigated?
A pregnancy test will be positive, and the investigation of choice is a transvaginal ultrasound.
What are the three management options for ectopic pregnancy?
Expectant management, medical management, and surgical management.
What criteria guide the management of ectopic pregnancy?
Size, symptomatology, fetal heartbeat presence, and hCG levels.
What is expectant management in ectopic pregnancy?
Closely monitoring the patient over 48 hours; intervention is performed if hCG levels rise or symptoms manifest.
What does medical management for ectopic pregnancy involve?
Administering methotrexate, requiring the patient to attend follow-up.
What is the first-line surgical management for ectopic pregnancy?
Salpingectomy for women with no other risk factors for infertility.
What should be considered for women with risk factors for infertility undergoing surgery for ectopic pregnancy?
Salpingotomy should be considered.
What is the most common natural history of ectopic pregnancy?
Tubal abortion and tubal absorption.
What happens during tubal absorption?
If the tube does not rupture, the blood and embryo may be shed or converted into a tubal mole and absorbed.
