MATERNAL LEC Flashcards
A pregnancy that
happens outside the
UTERUS.
Ectopic Pregnancy
Occurs when a zygote
implants in a location
that can’t support its
growth.
Ectopic Pregnancy
Most common site (95%) of implantation
Ampulla 55%; Isthmic 25%; Fimbrial 17%
Tubal
Pregnancy occurs when a fertilized egg implants on the surface of the
ovary.
ovarian
Extremely rare type (1/15,000); the developing embryo implants and
grows within the abdominal cavity.
abdominal
Rare implantation of a pregnancy in the endocervical canal.
Present with vaginal bleeding, which can be profuse and is often
painless.
cervical
Existence of two simultaneous pregnancies with separate implantation
sites.
One pregnancy is a viable intrauterine pregnancy (uterus)
The other non-viable ectopic pregnancy (outside the uterus).
Heterotopic
- Results from the gradual extension into the uterine cavity of products of
conception that originally implanted in the interstitial portion of the tube.
Tubo-uterine
- A zygote that is originally implanted at the end of the fallopian tube
gradually extends into the peritoneal cavity.
Tubo-abdominal
A zygote that is partly implanted in the tube & partly in the ovary
Tubo-ovarian
Additional symptoms during an ectopic pregnancy include:
Vaginal bleeding
Pain in your lower abdomen, pelvis, and lower back.
Dizziness or weakness.
Reveals extrauterine pregnancy
TVUS
In normal pregnancy, the HCG titer doubles every 48-72 hours;
in ET, it’s lower.
Serial HCG
Determination
Usually negative because HCG present in the urine & serum
level is not enough to be detected by pregnancy test.
. Pregnancy
Test
> 25 ng/ml normal viable pregnancy
<5 ng/ml is often associated with non-viable pregnancy (e.g.,
EP & abortion)
If serum levels are between 5-25 ng/ml, an ultrasound is
necessary
Serum
Progesterone
Levels
Direct visualization of the oviducts & ovaries.
Colpotomy
Extraction of fluid from the rectouterine pouch posterior to the
vagina through a needle.
Diagnose the presence of ruptured ectopic pregnancy
Culdocentesis
Falling hematocrit can discriminate slow internal bleeding from
the sudden hemorrhage of a ruptured tube.
Elevated WBC helps to aid in correct dx as PID and
appendicitis may have the same manifestations as EP.
CBC
For unruptured EP what kind of abortion?
therapeutic abortion is performed
(chemotherapy agent; immune suppressant)
Used to treat cancer, autoimmune diseases, and ectopic
pregnancies
Methotrexate
Stop fertilized eggs from growing, which ends pregnancy
Pregnancy then is absorbed by the body over 4-6 weeks
Does not require the removal of the fallopian tubes
Methotrexate
Methotrexate has been associated with
stomatitis,
gastritis,
hepatic enzyme
elevation,
pneumonitis, &
hematologic toxicity
is given on alternate days to
decrease the hematologic toxicity of Methotrexate.
IM leucovorin (like folic acid)
uncontrollable hemorrhage & severely
damaged tube
Salpingectomy
