Ectopic pregnancy

Question 1

Give 5 risk factors for ectopic pregnancy

Answer 1

PID Previous ectopic pregnancy Previous tubal surgery Endometriosis Intrauterine contraceptive device use: i.e Mirena coil

Question 2

What is the most common site for ectopic pregnancy location?

Answer 2

Ampulla

Question 3

What is the most dangerous site for ectopic pregnancy?

Answer 3

Isthmus

Question 4

What are the SSx of an ectopic pregnancy?

Answer 4

Amenorrhoea Iliac fossa pain Vaginal bleeding Shoulder tip pain (occasionally) Cervical and adnexal tenderness (occasionally) If ruptured: Syncope Hypotension

Question 5

1st line imaging for suspected ectopic?

Answer 5

Transvaginal USS

Question 6

Blood test for suspected ectopic?

Answer 6

Serum B-hCG

Question 7

What are the 3 types of management for an ectopic pregnancy and what are the indications for each?

Answer 7

Expectant Medical Mx - Methotrexate IM injection Surgical Ix - Salpingectomy/Salpingostomy

Question 8

Which intervention is most likely to reduce the chance of a subsequent ectopic pregnancy?

Answer 8

Salpingectomy

Question 9

What is the B-hCG level like in ectopic pregnancy?

Answer 9

Usually plateaus or increases every 48 hours but less than 66% of baseline