gynae ectopic Flashcards
risk factors for ectopic pregnancy
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
when would an ectopic likely rupture
6-12 weeks post last lmp
what kind of ectopic would probably go to the second trimester and what risks does this carry
cornual/interstitial ectopic
increased risk of hemorrhaging
historical features suggestive of an ectopic
missed period
lower abd pain and may have kehr sign positive(shoulder tip pain)
vaginal bleeding
dizziness/fainting -due to bleeding
How does one tell the difference between a pseudo gestational sac or a true sac
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
Ultrasound features of an ectopic
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
Ddx for an ectopic pregnancy
Ruptured corpus luteum
Threatened or incomplete miscarriage
Pid
Degenerating fibroids
What is the mainstay of medical treatment for ectopic pregnancy and what is the “antidote”
Methotrexate
Folinic acid