Ectopic pregnancy Flashcards
What is the definition of an ectopic pregnancy
The implantation of a fertilised egg outside of the uterine cavity
Where is the most common site for an ectopic to occur
Ampulla of the fallopian tube
What type of ectopic occurs when the egg implants in the uterine horn
Cornual ectopic
What is the classic presentation of an ectopic and why
Young women -> more likely to be pregnant
Severe lower abdo pain -> where the ectopic would likely occur
Amenorrhea -> no period as they’re bloody preggers
Afebrile -> excluded infections e.g. acute appendicitis
Vaginal bleeding -> part of the phsyiology bro
+ve pregnany test -> it’s pretty obvious now
Why do ectopic pregnancies cause vaginal bleeding
As unlike the uterus, the fallopian tubes (where an ectopic pregnanycy is most likely to occur) does not have the protective decidua layer
So, there is no protection from the trophoblast invasion -> which casues bleeding
What investigations are used for ectopic pregnancies
Serum B-hCG (increassed)
Serum progesterone (increased)
USS
Biopsy & microscopy
Pregnancy test
If a women presents with severe lower abdo pain, vaginal bleeding and absent periods, what test MUST you do
Pregnancy test
What are the signs of ectopic pregnancies that you should look out for on an USS
Lack of gestational sac
Thickened endometrial lining
Expanded fallopian tube
What is the main treatment for ectopic pregnancies
Methotrexate
What are the surgical treatments for ectopic pregnancies
Salpingostomy with excision of EP
Salpingectomy
What are the potential complications of an ectopic pregnancy
Haemorrhage
EP Ruputure
If a women with a suspected ectopic pregnancy presents to A&E after collapsing, and tests show that she has a high HR and low BP
What is suspected?
Ectopic pregnancy rupture
(a potetnial copmlication to an EP)
What are some of the risk factors to an ectopic pregnancy
Pelvic inflammatory disease
Previous tubal surgery (blocking/ligating the fallopian tube)
Previous EP
What are ectopic pregnancies associated with
Miscarriage
Ovarian torsion
Acute appendicitis
