Ectopic pregnancy

Question 1

What is the definition of ectopic pregnancy?

Answer 1

Attachment of embryo outside of uterus

Question 2

What are some risk factors of ectopic pregnancy?

Answer 2

History of ectopic pregnancy 
History of pelvic inflammatory disease 
Bicornuate uterus 
Endometriosis 
Intrauterine device

Question 3

What are the clinical features of ectopic pregnancy?

Answer 3

Clinical signs of pregnancy (amenhorea, breast tenderness, freq. urination)
Lower abdominal pain and guarding
Vaginal bleeding
Cervical motion tenderness

Question 4

What are the clinical features of tubal rupture?

Answer 4

Acute lower abdominal pain 
Hemorrhagic shock (tachycardia, hypotension, syncope)

Question 5

How is ectopic pregnancy diagnosed?

Answer 5

Beta-HCG test to confirm pregnancy

Transvaginal ultrasound to determine localisation and heartbeat (tubal ring sign)

Question 6

What are some of the differential diagnosis?

Answer 6

Benign neoplasms 
Ovarian cyst rupture 
Infection/inflammation 
Endometriosis 
PSOS 
Endometrial hyperplasia 
Endometria polyp

Question 7

What is the treatment for ectopic pregnancy?

Answer 7

Conservative or surgical. Hemodynamic support if necessary
Conservative - methotrexate, Anti-D immunoglobulin (RhoGAM)
Surgical - Laparoscopic removal, procedure known as Salpingostomy (either function preserving or non-function preserving)