Ectopic preg Flashcards
(20 cards)
What is the typical presentation of ectopic pregnancy?
Unilateral abdominal pain + amenorrhea + vaginal bleeding
What are common symptoms of ectopic pregnancy?
Abdominal pain, amenorrhea, vaginal bleeding
What is the first step in evaluating suspected ectopic pregnancy?
β-hCG test
What is the best initial imaging for ectopic pregnancy?
Transvaginal ultrasound
When is methotrexate used in ectopic pregnancy?
Stable patient + no fetal cardiac activity + β-hCG <5000 + no rupture
When is surgery indicated in ectopic pregnancy?
Unstable patient or signs of rupture
What β-hCG level is considered a discriminatory zone for ectopic pregnancy?
> 1500–2000 mIU/mL without intrauterine pregnancy on US
What findings on transvaginal ultrasound suggest ectopic pregnancy?
No intrauterine pregnancy + adnexal mass or free fluid
What is a sign of ruptured ectopic pregnancy?
Hemodynamic instability
What should you do if β-hCG is <1500 and no pregnancy seen on ultrasound?
Repeat β-hCG in 2 days
How should β-hCG levels behave in normal intrauterine pregnancy?
↑ by ≥35% in 48 hours
How do β-hCG levels change in ectopic pregnancy?
Abnormal rise or plateau in 48 hours
What medication is used for medical management of ectopic pregnancy?
Methotrexate
What are contraindications to methotrexate use in ectopic pregnancy?
Hemodynamic instability, liver/kidney disease, breastfeeding
What side effect should be monitored with methotrexate?
Abdominal pain due to tubal abortion
What is the follow-up after methotrexate treatment?
Serial β-hCG until undetectable
What is the definitive treatment in ruptured ectopic pregnancy?
Surgical intervention (salpingectomy or salpingostomy)
What physical exam finding may suggest rupture?
Rebound tenderness and cervical motion tenderness
What is the purpose of serial β-hCG measurements?
To assess pregnancy progression and guide diagnosis
What risk factors increase likelihood of ectopic pregnancy?
Tubal surgery, PID, IUD, prior ectopic pregnancy
