ECTOPIC PREGNANCY: QUESTIONS AND ANSWERS
LATEST UPDATE (GRADED A+)
What is an ectopic pregnancy (EP)?
any products of conception implanted outside of the endometrial cavity
What ? of pregnancies in the US are EP?
1.5-2%
What is the leading cause of 1st trimester pregnancy related deaths?
complications of EP
What % of maternal deaths are caused by EP?
6%
What % of EPs are stable at time of dx?
80%
What % of women have an EP with no known risk factors?
50%
What is the classic triad for EP?
pain, vag bleeding, adnexal mass
How many women present with the classic triad associated with an EP?
<45%
T or F: women with an EP will have a negative pregnancy test?
False, their test will be positive
How accurate is a pelvic ultrasound in diagnosing EP?
<50%
What % of women thought to have an EP actually have an IUP?
70-90%
T or F: you may see a GS on a TV exam even if you couldn't see it on an TA exam
True
What are some uncommon/signs you wouldn't expect to see with EP?
shoulder pain, guarding, hypovolemic shock, hypotension
, What is the treatment for an EP?
- spontaneous regression
- tubal abortion
- methotrexate
- surgery
What is the success rate for methotrexate (MTX)?
94%
When does trophoblastic tissue begin to make hCG?
8 weeks after conception
When do hCG levels rapidly begin to rise?
9-11wks
How much does hCG rise in 48hrs?
it doubles
What may be seen with an EP in regard to hCG?
- lower level
- lower level rise
- no pregnancy visualized despite discriminatory hCG
What are the two quantitative hCG lab tests?
- second international standard (2 IS) (1/2 IRP)
- international reference preparation (IRP) (2x IS)
What is the discriminatory zone in regard to hCG?
the threshold amount of hCG present at which there should be sonographic evidence of a GS
What is the discriminatory zone for 2 IS and IRP?
2 IS = 500-1200
IRP = 1000-2000
What will happen to hCG with abortion?
hCG will fall to 0
What will gestational trophoblastic neoplasia cause?
Excessively high levels of hCG
When will TA exam see an IUP in regard to hCG?
when hCG >6500
LATEST UPDATE (GRADED A+)
What is an ectopic pregnancy (EP)?
any products of conception implanted outside of the endometrial cavity
What ? of pregnancies in the US are EP?
1.5-2%
What is the leading cause of 1st trimester pregnancy related deaths?
complications of EP
What % of maternal deaths are caused by EP?
6%
What % of EPs are stable at time of dx?
80%
What % of women have an EP with no known risk factors?
50%
What is the classic triad for EP?
pain, vag bleeding, adnexal mass
How many women present with the classic triad associated with an EP?
<45%
T or F: women with an EP will have a negative pregnancy test?
False, their test will be positive
How accurate is a pelvic ultrasound in diagnosing EP?
<50%
What % of women thought to have an EP actually have an IUP?
70-90%
T or F: you may see a GS on a TV exam even if you couldn't see it on an TA exam
True
What are some uncommon/signs you wouldn't expect to see with EP?
shoulder pain, guarding, hypovolemic shock, hypotension
, What is the treatment for an EP?
- spontaneous regression
- tubal abortion
- methotrexate
- surgery
What is the success rate for methotrexate (MTX)?
94%
When does trophoblastic tissue begin to make hCG?
8 weeks after conception
When do hCG levels rapidly begin to rise?
9-11wks
How much does hCG rise in 48hrs?
it doubles
What may be seen with an EP in regard to hCG?
- lower level
- lower level rise
- no pregnancy visualized despite discriminatory hCG
What are the two quantitative hCG lab tests?
- second international standard (2 IS) (1/2 IRP)
- international reference preparation (IRP) (2x IS)
What is the discriminatory zone in regard to hCG?
the threshold amount of hCG present at which there should be sonographic evidence of a GS
What is the discriminatory zone for 2 IS and IRP?
2 IS = 500-1200
IRP = 1000-2000
What will happen to hCG with abortion?
hCG will fall to 0
What will gestational trophoblastic neoplasia cause?
Excessively high levels of hCG
When will TA exam see an IUP in regard to hCG?
when hCG >6500
