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MBBS miscarriage and ectopic pregnancy flashcards with practice questions
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A 32 year old woman, who had her last period 8 weeks ago, returns for review. She presented 2 days ago with light vaginal bleeding, but no pain. A pelvic ultrasound scan showed an empty uterus and a 2cm x 1.6cm echogenic mass around the left ovary. No free fluid was seen. Her beta HCG was 625 iu/L 48 hours ago. On examination today, she is non tender with blood pressure of 116/68 mmHg and a pulse of 80 beats/min. Her repeat beta HCG is 642 iu/L. What is the most appropriate management in this case?
A 32 year old woman, who had her last period 8 weeks ago, returns for review. She presented 2 days a...
METHOTREXATE INJECTION - this patient has been managed as expectantly with 48 hour review as she is clinically stable. The ultrasound scan suggests an ectopic in the left ovary but there is no evidence of rupture, as she is haemodynamically stable and there is no free fluid in the pelvis. Her serum HCG has plateaued, which suggests ectopic pregnancy rather than an intrauterine pregnancy (where levels would be expected to double) or a miscarriage (where levels would fall)
A 29 year old woman is referred from the emergency department with severe left iliac fossa pain. Her last menstrual period was 8 weeks ago and she had a positive pregnancy test. Past obstetric history is G1P1. On examination she appears unwell, with a blood pressure of 80/42mmHg and a pulse of 120 beats/min. She has left iliac fossa tendernous and cervical tendernous on vaginal examination. Pelvic ultrasound shows a left adnexal mass, obscured by free fluid demonstrating a foetal heartbeat. What is the most appropriate management in this case?
A 29 year old woman is referred from the emergency department with severe left iliac fossa pain. Her...
URGENT LAPAROTOMY - this woman requires emergency laparotomy due to haemodynamic instability and a live, bleeding ectopic pregnancy. The aim is rapid cessation of bleeding.
Name some predisposing risk factors for ectopic pregnancies
Name some predisposing risk factors for ectopic pregnancies
advanced maternal age, lower socio-economic background, any factor which damages the tube such as pelvic inflammatory disease, assisted conception, tubal surgery, previous ectopic pregnancy and being a smoker
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