Ectopic Pregnancy Flashcards
What is considered inappropriately rising beta-hCG levels?
<50% increase in 48 hours
What is the hCG level where an intrauterine pregnancy can be seen on ultrasound?
2,000 mIU/ml
Diagnosis of ectopic pregnancy:
inappropriately rising beta-hCG or levels that dont fall after diagnostic dilation and curettage; fetal pole visualized outside the uterus on ultrasound for which the pt would need a hcg level over the discriminatory zone(2,000)
What are the risk factors of ectopic pregnancy?
tenfold increase in women with prior ectopic; prior abdominal surgery and history of STI, sterilization failure, endometriosis and congenital uterine malformations
What is the expected progesterone level in pregnancy?
> 25 ng/ml suggests healthy pregnancy
Up to _____% of all normal pregnancies experience first trimester spotting/bleeding.
30%
What is an appropriate rise in beta-hCG in pregnancy?
level should rise by 50% every 48 hours until pregnancy is 42 days old
What is mifepristone?
progestin receptor antagonist and can be used as emergency contraception to prevent ovulation and blocks action of progesterone which is needed to maintain pregnancy; in US is also used with misoprostol for pregnancy termination
What is a heterotopic pregnancy?
ectopic and intrauterine pregnancy simultaneously
What conditions must be met prior to methotrexate for ectopic pregnancy?
hemodynamic stability, non ruptured ectopic pregnancy, ectopic mass <4cm without heart rate or <3.5cm with heart rate, normal liver and renal function, normal white count and ability of patient to followup rapidly
Signs of ruptured ectopic pregnancy?
signs of hypovolemia(tachycardia, hypotension), peritoneal signs, positive pregnancy test
In the setting of ruptured ectopic pregnancy, the standard of care for surgical management is?
removal of ectopic pregnancy and ruptured tube by salpingectomy; salpingostomy is possible in unruptured ectopic
