ECTOPIC PREGNANCY: QUESTIONS AND ANSWERS
LATEST UPDATE (GRADED A+)
What is an ectopic pregnancy?
Pregnancy outside of the uterine wall
Who has the highest mortality associated with ectopic pregnancy?
Teenagers
What is the #1 cause of first trimester maternal death?
Ectopic Pregnancy
What is the 2nd leading cause of maternal death overall?
Ectopic Pregnancy
What normally happens in pregnancy?
1) Fertilization occurs in the ampullary section of the fallopian tube
2) Then the zygote implants within the uterine wall
What are the major risk factors for ectopic pregnancy?
1) Pelvic Inflammatory Disease
2) History or tubal surgery
3) Use of intrauterine device
4) In utero exposure to deethylstibestrol (DES)
5) Assisted reproduction techniques
6) Previous ectopic pregnancy
Where do most ectopic pregnancies occur?
MOST OCCUR WITHIN THE FALLOPIAN TUBE
• Blood supply to the placenta is disrupted leading to bleeding into the fallopian tube and hematoma
formation
• The hematoma and the ensuing pressure can cause protrusion through the end of the fallopian tube or
rupture through the wall
, • Rupture is usually spontaneous
What is the classic triad for ectopic pregnancy?
1) Abdominal pain
2) Vaginal bleeding or spotting
3) Amenorrhea
What is the range of symptoms that can happen with ectopic pregnancy?
May range from completely asymptomatic (incidental finding) to sudden, severe abdominal pain and
hypovolemic shock
What is the MOST COMMON symptom of ectopic pregnancy?
Abdominal Pain
What causes the abdominal in ectopic pregnancy?
1) Due to tubal distention or rupture
2) Classically lateralized, sudden, sharp and severe
-There may be radiation to a shoulder-diaphragmatic irritation
3) ANY lateral or bilateral abdominal pain in a childbearing women needs Ectopic Pregnancy
consideration
What might I find in the history of abdominal pain?
1) Menstrual abnormality is often noted
•Amenorrhea-70% of the time
2) Vaginal bleeding-50-80%
•Usually scant, spotting
3) There may be a history of pregnancies
•The patient may "feel pregnant"
What is the #1 misdiagnosis for women of reproductive age + pelvic pain?
Ectopic Pregnancy (because the PE is usually nonspecific)
What might I note on PE if the patient with an ectopic pregnancy presents s/p rupture?
If the patient presents s/p rupture
•There may be signs of peritonitis
•Possible shock
LATEST UPDATE (GRADED A+)
What is an ectopic pregnancy?
Pregnancy outside of the uterine wall
Who has the highest mortality associated with ectopic pregnancy?
Teenagers
What is the #1 cause of first trimester maternal death?
Ectopic Pregnancy
What is the 2nd leading cause of maternal death overall?
Ectopic Pregnancy
What normally happens in pregnancy?
1) Fertilization occurs in the ampullary section of the fallopian tube
2) Then the zygote implants within the uterine wall
What are the major risk factors for ectopic pregnancy?
1) Pelvic Inflammatory Disease
2) History or tubal surgery
3) Use of intrauterine device
4) In utero exposure to deethylstibestrol (DES)
5) Assisted reproduction techniques
6) Previous ectopic pregnancy
Where do most ectopic pregnancies occur?
MOST OCCUR WITHIN THE FALLOPIAN TUBE
• Blood supply to the placenta is disrupted leading to bleeding into the fallopian tube and hematoma
formation
• The hematoma and the ensuing pressure can cause protrusion through the end of the fallopian tube or
rupture through the wall
, • Rupture is usually spontaneous
What is the classic triad for ectopic pregnancy?
1) Abdominal pain
2) Vaginal bleeding or spotting
3) Amenorrhea
What is the range of symptoms that can happen with ectopic pregnancy?
May range from completely asymptomatic (incidental finding) to sudden, severe abdominal pain and
hypovolemic shock
What is the MOST COMMON symptom of ectopic pregnancy?
Abdominal Pain
What causes the abdominal in ectopic pregnancy?
1) Due to tubal distention or rupture
2) Classically lateralized, sudden, sharp and severe
-There may be radiation to a shoulder-diaphragmatic irritation
3) ANY lateral or bilateral abdominal pain in a childbearing women needs Ectopic Pregnancy
consideration
What might I find in the history of abdominal pain?
1) Menstrual abnormality is often noted
•Amenorrhea-70% of the time
2) Vaginal bleeding-50-80%
•Usually scant, spotting
3) There may be a history of pregnancies
•The patient may "feel pregnant"
What is the #1 misdiagnosis for women of reproductive age + pelvic pain?
Ectopic Pregnancy (because the PE is usually nonspecific)
What might I note on PE if the patient with an ectopic pregnancy presents s/p rupture?
If the patient presents s/p rupture
•There may be signs of peritonitis
•Possible shock
