gynae ectopic

Question 1

risk factors for ectopic pregnancy

Answer 1

african descent
age
smoking

gynae hx:
iud use
hx of pid
emergency contraceptive w estogen 10x increase
infertility 
endometriosis 

uterine tumours
fibroids
adhesions

previous fallopian tube surgery
in vitro fertilization
any abd surgery
previous abortion

Question 2

when would an ectopic likely rupture

Answer 2

6-12 weeks post last lmp

Question 3

what kind of ectopic would probably go to the second trimester and what risks does this carry

Answer 3

cornual/interstitial ectopic

increased risk of hemorrhaging

Question 4

historical features suggestive of an ectopic

Answer 4

missed period
lower abd pain and may have kehr sign positive(shoulder tip pain)
vaginal bleeding
dizziness/fainting -due to bleeding

Question 5

How does one tell the difference between a pseudo gestational sac or a true sac

Answer 5

Pseudo mimics a true intrauterine sac. True sac is eccentrically placed within uterine cavity with DOUBLE RING SIGN. And intact midline endometrial echo. Pseudosac surrounded by SINGLE layer of tissue and midline endometrial echo cannot be seen

Question 6

Ultrasound features of an ectopic

Answer 6

Empty uterus

Adenexal mass seen as hyperechogenic tubal ring (doughnut or bagel sign) with empty uterus

Intrauterine or pseudogestational sac

Varying a mount of fluid in piuch of Douglas

Corpus luteum may be present

Question 7

Ddx for an ectopic pregnancy

Answer 7

Ruptured corpus luteum

Threatened or incomplete miscarriage

Pid

Degenerating fibroids

Question 8

What is the mainstay of medical treatment for ectopic pregnancy and what is the “antidote”

Answer 8

Methotrexate

Folinic acid