Ectopic pregnancy Flashcards
What is an ectopic pregnancy?
A pregnancy that implants outside the uterus.
What percentage of pregnancies in the UK are ectopic?
1%
What is the most common site of an ectopic pregnancy?
Fallopian/uterine tube
Where can an ectopic pregnancy implant?
Fallopian tube ovary Cornual (interstitium of the FT) Caesarean section scar Heterotopic pregnancy (uterine and ectopic pregnancy)
List 6 risk factors for ectopic pregnancy
- Previous PID
- Smoking
- Prior tubal surgery
- Previous STI (chlamydia in particular)
- Hx of infertility
- IUD/coil
What are common symptoms of ectopic pregnancy?
Pain (could be mild or severe, usually unilateral)
Shoulder tip pain (referred from diaphragmatic irritation from blood in the peritoneum)
Rectal pain
Diarrhoea
PV bleeding
Collapse, dizzy, syncope (hypovolaemia)
What would you look for on speculum examination?
cervical excitation or adnexal tenderness
What could be found on abdominal examination?
Guarding, rebound tenderness and distention (signs of pregnancy and peritonitis)
When does an ectopic pregnancy usually occur and why?
Between 5 and 7 weeks gestation as this is when the foetus grows to a size big enough to cause pain in the fallopian tubes and/or rupture
What are the 3 options for management of ectopic pregnancy?
- Surgical management
- Medical management
- Conservative management
What is a laparoscopic salpingectomy?
Removal of the fallopian tube via laparoscopic surgery
What is a laparoscopic salpingotomy?
Removal of the section of the fallopian tube with the ectopic pregnancy in. This can leave behind a damaged fallopian tube.
What medication is used for medical management of an ectopic pregnancy?
Methotrexate
What is the recurrence rate of an ectopic pregnancy in women who have had a salpingectomy?
10%
What is a common sign seen on USS of an ectopic pregnancy?
The donut sign
