Ectopic Pregnancy

Question 1

What is an ectopic pregnancy?

Answer 1

Occurs when a fertilised ovum implants outside the uterus, commonly in the fallopian tubes due to tubal dysfunction.

Question 2

List three risk factors for ectopic pregnancy.

Answer 2

• previous ectopic pregnancy
• previous pelvic inflammatory disease
• previous endometriosis

Question 3

At what gestational age do ectopic pregnancies usually present?

Answer 3

Around 6-8 weeks gestation.

Question 4

What are the classic symptoms of an ectopic pregnancy?

Answer 4

• constant unilateral abdominal pain
• pelvic pain and/or tenderness
• amenorrhoea
• vaginal bleeding

Question 5

True or False: Dizziness and shoulder tip pain can occur in ectopic pregnancies.

Answer 5

True

Question 6

What is the primary diagnostic tool for ectopic pregnancy?

Answer 6

Transvaginal ultrasound scan.

Question 7

What findings are indicative of ectopic pregnancy on a transvaginal ultrasound?

Answer 7

• empty uterus
• fluid in the uterus (pseudogestational sac)

Question 8

What happens to hCG levels in a normal pregnancy?

Answer 8

Levels will double every 48 hours.

Question 9

Fill in the blank: A rise of ______% in hCG indicates ectopic pregnancy.

Answer 9

<63%

Question 10

What is the indication for expectant management in ectopic pregnancy?

Answer 10

Haemodynamically stable and pain-free.

Question 11

When is methotrexate indicated in the management of ectopic pregnancy?

Answer 11

If unruptured ectopic and hCG <1500.

Question 12

What surgical procedures may be performed for ectopic pregnancy?

Answer 12

• Laparoscopic salpingectomy
• Laparoscopic salpingotomy

Question 13

What prophylaxis must be given for rhesus negative women undergoing surgery for ectopic pregnancy?

Answer 13

Anti-rhesus D prophylaxis.

Question 14

List two complications of untreated ectopic pregnancy.

Answer 14

• Fallopian tube rupture
• Massive haemorrhage