Ectopic Pregnancy Flashcards
ectopic pregnancy
embryo implants outwit the uterus
what is common place for it to implant
fallopian tubes
risk
pelvic inflammatory disease previous ectopic current coil IVF pelvic surgery endometriosis
signs
pain localised to an iliac fossa
vaginal bleeding
shoulder tip pain
amenorrhoea
investigations
beta hCG
trans-vaginal USS
management
conservative - regular monitor of beta hCG
medical - methotrexate
surgical - salpingectomy or salpingostomy
when would you do conservative management
fetal mass <35mm
no heart beat detected
asymptomatic
beta hCG <1000
when would you do medical management
fetal mass <35mm
no heart beat detected
mild symptoms
beta hCG <1500
when would you do surgical management
fetal mass >35mm
heart beat detected
intense pain
beta hCG>5000
when would you do salpingostomy over of salpingectomy
preserve fertility
preserve fallopian tube
what is a differential diagnosis
miscarriage
what are two differentiating factors between miscarriage and ectopic pregnancy
in ectopic, pain is the first and dominant symptoms
and light bleeding compared to miscarriage
how would you manage a ruptured ectopic pregnancy
resuscitate and arrange emergency laparotomy
what would be seen on an x-ray for ruptured ectopic pregnancy
air under diaphragm
what location has the highest risk of rupture
isthmus
