Ectopic pregnancy

Question 1

What is an ectopic pregnancy?

Answer 1

An ectopic pregnancy is when the embryo implants outside the uterus.
The embryo may implant in the abdomen but more often it is a tubal pregnancy, most commonly (80%) located in the ampulla region of the fallopian tube.

Question 2

What causes an ectopic pregnancy?

Answer 2

An ectopic pregnancy can be caused by anything that narrows or damages the fallopian tube such as:
The progesterone only pill - causes thickened secretions.
Infection.
IVF treatment.
PID.
Adhesions.

Question 3

What are the symptoms of an ectopic pregnancy?

Answer 3

The symptoms of an ectopic pregnancy include:
Abdominal pain - colicky - usually RLQ or LLQ
Vaginal bleeding - dark coloured
Nausea & vomiting
Signs of shock - clammy, pale, tachycardia, hypotensive
Cervical excitation on vaginal examination

Question 4

What are the investigation for an ectopic pregnancy?

Answer 4

Investigations for an ectopic pregnancy include:
Pregnancy test
ß-hCG levels
FBC
U&E
Group & save
Trans vaginal USS

Question 5

What is the treatment for an ectopic pregnancy?

Answer 5

Treatment for an ectopic pregnancy includes:
Emergency if needed: ABCDE assessment, IV access, IV fluids, X-match +/- transfusion, ?anti-D phrophylaxis

Medical:- Methotrexate

Surgical:- Laparoscopic salpingotomy/salpingectomy

Question 6

What are the complications of an ectopic pregnancy?

Answer 6

Complications of an ectopic pregnancy include:
Rupture.
Subfertility issues
Increased risk of further ectopics
Psychological issues related to loss, subfertility and increased risk