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11 Cards in this Set
- Front
- Back
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What is an ectopic pregnancy |
Implantation of the blastocyst outside the endometrium cof the uterus |
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What are the risk factors to develop an ectopic? |
Previous ectopic pregnancy Previous tubal surgery for sterilization,ectopic,fertility History of Pelvic Inflammatory Disease Pelvic adhesions from previous appendicitis or endometriosis Smoking Use of ART to overcome fertility Use of progesterone only OCP and Intrauterine devices(copper) when they fail |
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What are the outcomes of a tubal pregnancy? |
Tubal abortion Tubal rupture Pregnancy failure with resolution |
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What is the classical triad of late ectopic presentation? |
History of amenorrhoea Abdominal pain Vaginal bleeding or spotting |
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What are the differential diagnosis of lower abdominal pain and bleeding per vaginum in a female |
Ectopic pregnancy Cystitis Salpingitis Urinary tract infection Ovarian mass(torsed,hemorrhagic,ruptured) Round ligament pain Appendicits Miscarriage Molar pregnancy Leiomyomas(red degeneration) Renal stones Gastroenteritis Tuboovarian abscess |
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What are the 4 modalities for diagnosing an ectopic? |
USS, BhCG, physical findings and laparotomy |
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What are the differentials for failure to visualise uterine pregnancy above the discriminatory zone |
Completed abortion Ectopic pregnancy Failed uterine pregnancy |
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What is the mechanism of action of methotrexate? |
It is a folic acid antagonist inhibiting the enzyme dihydrofolate reductase blocking the reduction of dihydrofolate to tetrahydrofolate thus purines and pyrimidines cannot be synthesised blocking DNA |
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What are the side effects of methotrexate |
GI mucosa injury Bone marrow disruption Respiratory epithelium injury Hepatotoxic Nephrotoxix Potent teratogen Excreted into breast milk |
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What are the contraindications for methotrexate use ? |
Ruptured ectopic Breastfeeding Presence of fetal heart beat Intra uterine pregnancy Hepatic,renal,hematological dysfunction Peptic ulcer disease Active pulmonary disease Evidence of immunodefeciency |
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When can medical therapy be used to treat ectopic |
Hemodynamically stable Unruptured ectopic No intra abdominal hemorrhage BhCG levels less than 3000 IU/L Tubal pregnancy diameter less than 4 cm without fetal cardiac activity |
