Ectopic Pregnancy Flashcards
What is ectopic pregnancy ?
It’s a condition where the developing blastocyst becomes implanted at a site other than the endometrium of e uterine cavity .
There’s a seasonal variation occueswit ectopic pregnancy so it is more common in ?
June and December
The overall incidence of ectopic pregnancy among women with first trimester bleeding with pain is ?
6-16%
Most common site for ectopic pregnancy is ?
Fallopian tube 98%
Rare sites for ectopic pregnancy ?
-Heterotopic pregnancy
-Hysterectomy scar pregnancy
-rudimentary uterine horn pregnancy
Sites for ectopic pregnancy other than fallopian tubes?
Ampullary
Ovarian
Abdominal
Cervical
Isthmic
Interstitial
High Risk factors for ectopic pregnancy ?
-previous ectopic pregnancy 15%
Tubal surgery and pathology (infection /tumor)
-in utero DES exposure (9 folds) increase in risk
Moderate risk factors ?
-Previous genitalia infection (especially with chlamydial infection .
-IUD (if pregnancy occurs while using IUD then the women is in a high risk for having ectopic pregnancy
Mild ectopic pregnancy risk factor ?
-Smoking
-Age less than 18 at first sexual encounter
- multiple sexual partner
The classic symptoms of ectopic pregnancy ?
Abdominal pain
Amenorrhea
Vaginal bleeding
Associated symptoms with ectopic pregnancy other than the classic tirade ??
-Shoulder pain (due to diaphragm irritation )
-Difficult defecation (due to pooling of blood in pouch of Douglas )
-lightheadness due to tubal rapture
Ectopic pregnancy physical examination findings ?
-Low grade fever
-Orthostatic changes on vital signs
-abdominal tendrness
-mild uterine enlargement
-adnexal mass
How do diagnose ectopic pregnancy ?
-us (transvaginal )
Transvaginal findings for ectopic pregnancy (pseudo sac) ?
- pseudo sac : small fluid collection that is located within centrally within the endometrial cavity and surrounded with hick decidual reaction .
- absence of double decidual sac sign
-tends to be located in the middle of the uterine cavity
Can change in shape during the sac
Decrease blood flow on Doppler
The presence of a yolk sac with in the endometrium is diagnostic for?
Intrauterine pregnancy