Ectopic Pregnancy Flashcards
What pathologies increase risk of ectopic?
PID
STIs
Tubal stricture
What are the iatrogenic causes of ectopic?
Pelvic surgery
IVF
Contraception
- Especially IUD and COIL
What is the biggest risk factor for ectopic?
Previous ectopic
Typical presentation?
May not even know they were pregnant
- Always had an erratic cycle
Intermenstrual, rusty bleeding that isn’t too heavy
Iliac fossa pain
Shoulder tip pain
- If ruptured
What is used to differentiate between a ruptured ectopic and appendicitis?
MacBurney’s point
Chandelier’s sign
What is chandeliers sign?
Severe pain on bimanual cervical motion
So severe they throw hands up in the air like a chandelier
What is the most common site of ectopic pregnancy?
Ampulla
What are other sites of ectopic in increasing unlikeliness?
Isthmus Cornual (interstitial - top of uterus)
Investigations in suspected ectopic?
Pregnancy test
Vaginal exam
Bloods
TVUS!!!!!! most important
What will be seen on vaginal exam in ectopic?
- Cervical tenderness –> chandelier’s sign
What bloods should be done?
b-HCG
Progesterone
What are the bloodwork findings?
b-HCG - slow rising
Very high progesterone
What may be seen on TVUS?
Bagel sign
Management of non ruptured ectopic?
Methotrexate
What advice must be given to a woman taking methotrexate?
Use contraception for 3 months after it as teratogenic
