ECTOPIC PREGNANCY: QUESTIONS AND ANSWERS LATEST UPDATE (GRADED A+)

ECTOPIC PREGNANCY: QUESTIONS AND ANSWERS
LATEST UPDATE (GRADED A+)
Ectopic Pregnancy

Fertilized ovum that implants in any place other than endometrial cavity

Etiology of Ectopic Pregnancy

• Mechanical obstruction or abnormality in the movement of embryo through the fallopian tube

• 1st ectopic pregnancy documented in 1638

Fallopian Tubes

Paired musculo- membranous structures

Interstitial/intramural portion of Fallopian Tube

Narrowest segment
- passes through the muscular wall of the uterine corpus
- most dangerous site for an ectopic (2.5%)

Isthmus portion of Fallopian Tube

Adjacent to the uterus (3%)

Ampulla portion of Fallopian Tube

Longest segment
- Tortuous course & widens at distal end
- Most common site for an ectopic - 93%

Infundibulum/fimbriated extremity portion of Fallopian Tube

distal portion the tube that resembles a petunia

Sites for Ectopic Pregnancy

Fallopian Tubes
- Ampulla - MC 93%
- Isthmus - 3%
- Interstitial or corneal - 2.5%
- Fimbrae

Ovary - rare
Cervix
Abdominal cavity/ implantation

Primary vs. Secondary Ovarian Implantation

, Primary = fertilization takes place in ovaries

Secondary = results in tubal abortion

Classic Triad of Symptoms for an Ectopic Pregnancy

Pain
Abnormal vaginal bleeding
Adnexal mass

Addition symptoms for an Ectopic Pregnancy

(+) pregnancy test
Ruptured Ectopic pregnancy
Pallor
Clammy skin
Sweating
Tachycardia
Hypotension
Right shoulder pain - fluid in Morison's pouch

2 types of hCG tests

1) Urine or Serum

2) Quantitative

Urine or Serum hCG

Serum = most accurate to test pregnancy

Detects hCG in bloodstream

Quantitative hCG test

Normal IUP - 2x every 2-3 days

Ectopic pregnancy = increases slowly

At 1000 units = IUP seen on TV

Ruptured Ectopic Pregnancy results in increased & decreased what?

Increases Serum amylase

Decreases Hematocrit

Risk Factors for Ectopic Pregnancy

Previous ectopic
PID