gynae ectopic Flashcards

1
Q

risk factors for ectopic pregnancy

A

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

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2
Q

when would an ectopic likely rupture

A

6-12 weeks post last lmp

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3
Q

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

A

cornual/interstitial ectopic

increased risk of hemorrhaging

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4
Q

historical features suggestive of an ectopic

A

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

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5
Q

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

A

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

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6
Q

Ultrasound features of an ectopic

A

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

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7
Q

Ddx for an ectopic pregnancy

A

Ruptured corpus luteum

Threatened or incomplete miscarriage

Pid

Degenerating fibroids

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8
Q

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

A

Methotrexate

Folinic acid

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