Ectopic Pregnancy

Question 0

Differentiating cervical ectopic from inevitable abortion (miscarriage)

Answer 0

Ectopic preg GS will have a ring around it

Question 1

What are a few causes for inc risk for ectopics

Answer 1

Endometriosis
Pelvic Inflammatory Disease
Ovarian Tumor
IUDS (Intra Uterine Device)
Previous Fallopian Tube Surgery
IVF (In Vitro Fertilization)
Inc age and parity 
Cesarean Section

Question 2

Ectopic

Answer 2

Pregnancy outside of endo cavity

Inc risk with infertility treatments, PID, hx of ectopics, tube surgery, endometriosis, IUD, miscarriage, adnx mass

Leading cause of maternal death, 10xs more than child birth

95% in Fallopian tube.
Other sites: cervix, abdomen, cornu, ovary

FF

Question 3

Heterotopic pregnancy

Answer 3

IUP & ectopic

Question 4

Clinical Triad

Answer 4

Pain
Abnl bleed
Adnexal mass

Question 5

HCG

Answer 5

Plateau or sub normal
800-1000mIU/ml shows gest sac
Inc serum amylase if rupture

Question 6

Desidual Cyst Sign

Answer 6

1-5 mm cyst in endo & close to myometrium.

Question 7

Pseudogestational sac sign

Answer 7

Looks like GS without double sac sign. Not in endo.

Question 8

Adnexal ring sign

Answer 8

Adnexal mass

Question 9

Interstitial string sign

Answer 9

Line from endo to sac

Question 10

Fluid

Answer 10

CDS fluid, also in Morison’s Pouch

Question 11

Cornu/Interstitial ectopic

Answer 11

Very dangerous. Massive hemorrhage. Highly vascular.

Question 12

Rupture occurs

Answer 12

6-12wks

Question 13

Ectopic > 12 wks

Answer 13

Abdominal pregnancy

Question 14

Most frequent US finding

Answer 14

Adnexal mass & ff

Question 15

95% of ectopics in

Answer 15

Fallopian tube. Tubal pregnancy