MATERNAL EMERGENCIES
BEFORE 20 WEEKS
,Ectopic pregnancy
Embryo implantation outside of the
endometrial cavity
The classic triad of abdominal pain,
vaginal bleeding, and amenorrhea
,Ectopic pregnancy
, EXPECTANT MANAGEMENT
Ectopic pregnancy For patients who are haemodynamically stable and
asymptomatic
Patient requires serial hCG measurements until levels
are undetectable
MEDICAL MANAGEMENT: METHOTREXATE
Indications:
Minimal symptoms
Adnexal mass <40mm in diameter
Current serum hCG <3000 IU/L
MECHANISM OF ACTION
Folic acid antagonist inhibits deoxyribonucleic acid (DNA)
synthesis particularly affecting trophoblastic cells
DOSAGE
Calculated based on patient's body surface area and is
50 mg/㎡
After treatment, serum hCG level is routinely measured
on day 4, 7 and 11, then weekly thereafter until
undetectable
BEFORE 20 WEEKS
,Ectopic pregnancy
Embryo implantation outside of the
endometrial cavity
The classic triad of abdominal pain,
vaginal bleeding, and amenorrhea
,Ectopic pregnancy
, EXPECTANT MANAGEMENT
Ectopic pregnancy For patients who are haemodynamically stable and
asymptomatic
Patient requires serial hCG measurements until levels
are undetectable
MEDICAL MANAGEMENT: METHOTREXATE
Indications:
Minimal symptoms
Adnexal mass <40mm in diameter
Current serum hCG <3000 IU/L
MECHANISM OF ACTION
Folic acid antagonist inhibits deoxyribonucleic acid (DNA)
synthesis particularly affecting trophoblastic cells
DOSAGE
Calculated based on patient's body surface area and is
50 mg/㎡
After treatment, serum hCG level is routinely measured
on day 4, 7 and 11, then weekly thereafter until
undetectable
