OB Case- Ectopic Pregnancy

Question 1

What is absolutely essential to remember when using methotrexate (MTX) to treat an ectopic pregnancy?

Answer 1

• assess for 15% DECREASE IN B-hCG between DAYS 4 and 7. If not at least 15% decrease, then administer a second dose of of MTX!!!

Question 2

What should be on your DDx for ectopic pregnancy?

Answer 2

• acute appendicitis
• spontaneous abortion (miscarriage)
• ovarian torsion
• PID
• ruptured corpus luteum cyst or follicle
• tub0ovarian abscess
• urinary calculi

Question 3

What are the risk factors for ectopic pregnancy?

Answer 3

• PID
• prior ectopic pregnancy
• endometriosis
• tubal surgery
• pelvic surgery
• infertility and Tx’s
• uterotubal anomalies
• DES in utero exposure
• cigarette smoking

Question 4

What is leading cause of death in the first trimester of pregnancy?

Answer 4

• ectopic pregnancy