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10 Cards in this Set
- Front
- Back
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definition of ectopic pregnancy?
Incidence? ** |
Pregnancy outside the uterine corpus
Incidence – 20 per 1000 |
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most common site of ectopic preg?
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Tubual-ampulla
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Differentiate early pregnancy bleeding from ectopic pregnancy
objective |
YOU CANNOT TELL THE DIFFERENCE
must do ultrasound and hormone levels (HCG, progesterone) |
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after 1 ectopic pregnancy, what is the likelihood that you will have another?
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After 1 ectopic 12% subsequently ectopic
10 fold increase after 2 |
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what are some of the risk factors for ectopic pregnancy?
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Prior ectopic pregnancy
History of PID History of tubal ligation History of tubal reversal or other prior tubal surgery Mullerian anomalies Progesterone containing IUD (Mirena) Assisted reproduction DES exposure Cigarette smokers 2 fold increase |
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if a pt has an IUD and gets pregnant, what do you need to consider?
* |
Ectopic pregnancy
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female pt presents with a tender abdomen that is distended. She is tachycardic and has low hemoglobin and intrabdominal fluid...what is likely going on?
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Ruptured ectopic pregnancy
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What is the only medical tx to help treat an ectopic pregnancy? How does it work?
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Methotrexate: folic acid inhibitor – interferes with DNA synthesis
terminates the pregnancy and saves the fallopian tube note: have to have abnormally rising/high and stable hCG along with a mass less than 4cm (if above, use surgical tx: salpingectomy) |
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Standard of care for an ectopic pregnancy?
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Salpingectomy
(surgical removal of a Fallopian tube) note: have to have abnormally rising/high and stable hCG along with a mass greater than 4cm (if below, use medical tx) |
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Patient is a 25 yo prostitute with multiple elective abortions in the past. She has had a history of a “pelvic infection”. She had a light period 2 weeks ago and now complains of bleeding and pelvic pain after sex. Her urine pregnancy test is positive. Ultrasound does not show an intrauterine pregnancy but a sac in the left adnexa, with a moderate amount of free fluid in the cul de sac. P = 80, Hg = 9.8
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Ectopic Pregnancy
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