Location, Location, Location
S & S
Risk Factors
May I speak to your manager?
What's that Dx
100
Abdominal cavity, isthmus, cornua, ovary
What are rare locations for ectopic pregnancy to occur
100
First trimester bleeding and crampy abdominal pain
What is something that should increase your index of suspicion for ectopic pregnancy
100
Contraceptive failure
What is a common reason for ectopic pregnancy
100
Unruptured fallopian tube, falling bhCG, no significant bleeding
What are criteria that make it ok to proceed with expectant management.
100
Intrauterine pregnancy
What is the first thing that should be ruled out
200
Transvaginal US
What is the method by which to locate the ectopic pregnancy or confirm intrauterine pregnancy
200
Rebound tenderness
What is a common finding in ruptured ectopic pregnancy that may lead to needing to rule out appendicitis
200
Sexually Transmitted Disease (esp. that which progresses to Pelvic Inflammatory Disease)
What is a common cause of ectopic pregnancy
200
Reliable, stable, competent patient requesting future fertility; no intrauterine pregnancy, ectopic pregnancy <4cm
What are criteria for proceeding with medical management
200
Spontaneous abortion (missed, threatened)
What is something that must be ruled out before deciding on medical management
300
Shoulder pain
What is a symptom of a diaphragm irritation from a ruptured ectopic pregnancy
300
Missed menstrual period, fatigue, nausea, and sore breasts
What are symptoms of intrauterine pregnancy and unruptured ectopic pregnancy
300
DES exposure
What is a cause of ectopic pregnancy that we should not be seeing anymore in reproductive aged women
300
Breastfeeding, immunodeficiency, known sensitivity to MTX, active pulmonary disease, PUD, hepatic, renal or heme dysfunction
What are absolute contraindications to medical management
300
Appendicitis, adnexal torsion
What are conditions that can present similar to ectopic pregnancy but can occur in women who aren't pregnant
400
Gestational age, expertise of the sonographer
What are limitations to sensitivity of TVUS in diagnosing ectopic pregnancy
400
Subfertility
What is a common result of injury to fallopian tube following ruptured fallopian tube or surgical management
400
Cigarette smoking, Age >35, many lifetime sexual partners, subfertility
What are minor risk factors for ectopic pregnancy
400
Salpingectomy, salpingostomy
What are preferred methods of laparoscopic surgical management
400
Bleeding corpus luteum, ruptured ovarian cyst
What are conditions of the ovary that can present like a ruptured ectopic pregnancy
500
Ampulla
What is the most common location for ectopic pregnancy to occur
500
Hypotension, tachycardia, dizziness, syncope
What are signs and sx of shock resulting from ruptured ectopic pregnancy
500
Previous ectopic pregnancy
What is one of the highest risk factors
500
Reserved for patients with intraperitoneal bleeding, intravascular compromise, poor visualization of the pelvis at the time of laparoscopy
What is laparotomy
500
TVUS +bhCG
What are 2 of the first things needed to make the dx of ectopic pregnancy
M
e
n
u