ECTOPIC PREGNANCY

Question 0

RFs for ectopic?

Answer 0

Previous ectopic 
Precious Fallopian tube damage 
- tubal surgery 
- Pid
- tubal pathology 
IVF 
IUD

Question 1

What is an ectopic pregnancy?

Answer 1

When the fertilized zygote fails to reach uterus and implants outside in the Fallopian tube.

Question 2

Presentation of ectopic?

Answer 2

Most commonly 6-8 weeks after LMP
TRIAD
- abdominal pain
- amenorrhea
- PV bleeding

Question 3

Ix for ectopic?

Answer 3

CBE EUC LFT CRP
COAGS BLOOD GROUP
B-HCG
- if doubles in 48 he's -> viable pregnancy 
- ectopic -> fails to double 

US TV

Question 4

Management of ectopic?

Answer 4

If haemodynamically unstable -> laparotomy/scopy

Stable

• HCG < 1500, wait and repeat HCG
• HCG > 1500 no sac on US
• > surgical laparoscopic salpingectomy
• > medical: IM methotrexate (contraindicated: active bleeding)