ECTOPIC PREGNANCY: QUESTIONS AND ANSWERS
LATEST UPDATE (GRADED A+)
Be sure to think of THIS is woman of childbearing age with abdominal pain (EVERY TIME)
Ectopic pregnancy
(or Dr. Mary will stomp on your head)
m/c time for ectopic pregnancy to present
1st trimester
Discriminatory Zone
Level of hCG at which a gestational sac should be visible by transvaginal US
Usually 2000IU (some say it is 3510)
Ectopic pregnancies account for _____% of pregnancies
2%
m/c cause of DEATH in the first trimester
Ectopic pregnancy
m/c location for ectopic pregnancy
uterine tubes (98%)
Besides the uterine tubes, what are other sites for ectopic pregnancy
Peritoneum
Abdominal viscera
Ovary
Cervix
Incidence of ectopic pregnancy in the US has risen with increased incidence of ________
Chalmydial infections
Three outcomes possible with tubal pregnancy
1. Tubal abortion
2. Spontaneous resolution
3. Tubal rupture
Tubal abortion
Conceptus sent out tube into abdominal cavity where it dies
, Spontaneous resolution of tubal pregnancy
Conceptus dies and is expelled vaginally
Tubal rupture
Uterine tube ruptures as a result of the tubal pregnancy
Hemorrhage can ensue and lead to significant M&M
Classic presentation of ectopic pregnancy
F patient of reproductive age with positive urine or serum hCG and one or both:
-vaginal bleeding
-lower abdominal or pelvic pain
Typical presentation of ectopic pregnancy is ________ after the first day of LMP
6-8 weeks
Are signs/symptoms of pregnancy present with ectopic pregnancy
Can have amenorrhea, breast tenderness, and N/V
Usually NOT since they don't have same levels of hormones
As many as 50% of women with tubal ectopic pregnancy present with _______
rupture
(will have SEVERE lower quadrant pain)
High risk of tubal pregnancy IF
Previous ectopic
Previous tubal surgery
Tubal pathology (salpingitis, salpingitis isthmica nodosa)
Moderate risk of tubal pregnancy IF:
Current IUD use
Infertility
Previous cervicitis (gonorrhea/chlamydia)
Hx of PID
Multiple sex partners
Smoking
Progestin only birth control
IVF
Hormones that induce ovulation
Why does progesterone only birth control moderately increase risk of ectopic pregnancy
LATEST UPDATE (GRADED A+)
Be sure to think of THIS is woman of childbearing age with abdominal pain (EVERY TIME)
Ectopic pregnancy
(or Dr. Mary will stomp on your head)
m/c time for ectopic pregnancy to present
1st trimester
Discriminatory Zone
Level of hCG at which a gestational sac should be visible by transvaginal US
Usually 2000IU (some say it is 3510)
Ectopic pregnancies account for _____% of pregnancies
2%
m/c cause of DEATH in the first trimester
Ectopic pregnancy
m/c location for ectopic pregnancy
uterine tubes (98%)
Besides the uterine tubes, what are other sites for ectopic pregnancy
Peritoneum
Abdominal viscera
Ovary
Cervix
Incidence of ectopic pregnancy in the US has risen with increased incidence of ________
Chalmydial infections
Three outcomes possible with tubal pregnancy
1. Tubal abortion
2. Spontaneous resolution
3. Tubal rupture
Tubal abortion
Conceptus sent out tube into abdominal cavity where it dies
, Spontaneous resolution of tubal pregnancy
Conceptus dies and is expelled vaginally
Tubal rupture
Uterine tube ruptures as a result of the tubal pregnancy
Hemorrhage can ensue and lead to significant M&M
Classic presentation of ectopic pregnancy
F patient of reproductive age with positive urine or serum hCG and one or both:
-vaginal bleeding
-lower abdominal or pelvic pain
Typical presentation of ectopic pregnancy is ________ after the first day of LMP
6-8 weeks
Are signs/symptoms of pregnancy present with ectopic pregnancy
Can have amenorrhea, breast tenderness, and N/V
Usually NOT since they don't have same levels of hormones
As many as 50% of women with tubal ectopic pregnancy present with _______
rupture
(will have SEVERE lower quadrant pain)
High risk of tubal pregnancy IF
Previous ectopic
Previous tubal surgery
Tubal pathology (salpingitis, salpingitis isthmica nodosa)
Moderate risk of tubal pregnancy IF:
Current IUD use
Infertility
Previous cervicitis (gonorrhea/chlamydia)
Hx of PID
Multiple sex partners
Smoking
Progestin only birth control
IVF
Hormones that induce ovulation
Why does progesterone only birth control moderately increase risk of ectopic pregnancy
