Extrauterine Pregnancy Flashcards
(21 cards)
What is an extrauterine (ectopic) pregnancy?
Implantation of a fertilised ovum outside the uterine cavity.
What is the most common site of ectopic pregnancy?
The fallopian tube (97%), with 80% in the ampulla.
Name 3 types of extrauterine pregnancy aside from tubal.
Ovarian, abdominal, cervical.
State the classic clinical triad of ectopic pregnancy.
Amenorrhoea, abdominal pain, vaginal bleeding.
What percentage of ectopic pregnancies present with the classic triad?
50%
List 4 risk factors for ectopic pregnancy.
PID, previous pelvic surgery, smoking, previous ectopic pregnancy, DES exposure.
What serum marker is essential for diagnosing ectopic pregnancy?
Serum β-hCG.
What is the discriminatory β-hCG level for transvaginal USS?
1500–1800 IU/L.
What is the most important tool for diagnosing ectopic pregnancy?
Ultrasonography (USS).
What is the gold standard for diagnosing ectopic pregnancy?
Laparoscopy.
Name the three categories of ectopic pregnancy management.
Expectant, medical, surgical.
State 3 prerequisites for expectant management.
Asymptomatic, β-hCG <1500 IU/L, haemodynamically stable.
What is the standard drug for medical management of ectopic pregnancy?
Methotrexate.
Name 2 contraindications to laparoscopy in ectopic pregnancy.
Haemodynamic instability, ruptured ectopic.
When is laparotomy preferred over laparoscopy?
Haemodynamic instability, uterine cornual EP, or lack of laparoscopic expertise/facilities.
What is the indication for salpingotomy over salpingectomy?
Desire to preserve fertility, stable patient, accessible unruptured EP <5 cm, damaged/absent contralateral tube.
What are 3 key investigations before medical/expectant management?
β-hCG, liver and renal function tests, blood group and cross-match.
Name 3 differential diagnoses of ectopic pregnancy.
Appendicitis, salpingitis, ruptured corpus luteum, ovarian torsion.
What is a heterotopic pregnancy?
Coexistence of intrauterine and extrauterine pregnancies.
What is a pregnancy of unknown location (PUL)?
No visible intrauterine pregnancy on USS despite β-hCG above discriminatory zone.
What is the commonest cause of maternal mortality in early pregnancy?
Ectopic pregnancy.
