Ectopic pregnancy || A+ Graded Already.
How do we define ectopic pregnancy? correct answers Implantation of a blastocyst in a location
other than in the uterine cavity
What is the classic triad of ectopic symptoms? correct answers Pain
Amenorrhea
Spotting or bleeding
What are the three categories of ectopic pregnancies? correct answers Intrauterine, extrauterine,
heterotopic
What are the treatment options for ectopic? correct answers Medical
Surgical
Expectant management
Which is preferable, medical or surgical management of ectopic? correct answers Medical
management is preferable to even "conservative" surgical procedures whenever feasible, esp in
asymptomatic women with early unruptured EP
In what location might an intrauterine ectopic occur? correct answers Gestation in cervix or
cornua
In what location might an extrauterine ectopic occur? correct answers Fallopian tube, ovary,
abdomen, broad ligament
In what location might an heterotopic pregnancy occur? correct answers Implantation in both
uterine cavity and in an ectopic site (usually tube)
When are heterotopic pregnancies more likely? correct answers With pregnancy resulting from
IVF
Which type of ectopic is most common? correct answers Tubal (97%)
How are tubal ectopics classified? correct answers By location: ampullary, isthmic, fimbrial,
cornual/insterstital
What type of tubal ectopic is most common? correct answers Ampullary
Why is ampullary ectopic so common? correct answers Because it is where fertilization usually
occurs
When will a woman with an isthmic ectopic become symptomatic? correct answers Earlier rather
than later (6-7w?)
, Why will a woman with an isthmic ectopic become symptomatic earlier? correct answers
Because it that part of the tube is so narrow
What is the most distal part of the fallopian tube? correct answers Fimbriae
What can happen to the products of conception in a fimbrial ectopic? correct answers They can
be expelled into the peritoneal cavity
Why do interstitial ectopics generally rupture later rather than earlier? correct answers Thicker
portion of the tube partially surrounded by myometrium
When would rupture generally occur with an interstitial ectopic? correct answers 9-12w
What is a possible etiology of ectopic related to implantation? correct answers Mechanical
interference with implantation: IUC, hormonal dysfunction, sterilization failure
What are some factors considered high risk for ectopic? correct answers Prior ectopic pregnancy
Tubal pathology & surgery
In utero DES exposure
What is the chance of recurrence with prior ectopic pregnancy? correct answers 33%
What kind of infection can result in tubal pathology? correct answers Chlamydia, GC,
polymicrobial
What is the relationship between IUDs and ectopic? correct answers Doesn't cause EP but if a
pregnancy occurs there's a greater risk that the pregnancy is EP
What type of infertility is of greatest risk for ectopic? correct answers Patients with primary
infertility due to tubal factors that prohibit or delay ovum transport
What are some surgical risk factors for ectopic? correct answers History of pelvic or abdominal
procedures
What lifestyle factor is known to increase risk of ectopic? correct answers Smoking (dose
dependent), multiple partners, early age of 1st intercourse
What percentage of women with ectopic will have NO identifiable risk factors or initial
definitive physical findings? correct answers 50%
What kind of pain is associated with ectopic? correct answers Abdominal usually monitor pelvic,
shoulder
What kind of pain suggests rupture? correct answers Sharp, sudden, stabbing
What might exacerbate abdominal pain due to ectopic? correct answers Movement
How do we define ectopic pregnancy? correct answers Implantation of a blastocyst in a location
other than in the uterine cavity
What is the classic triad of ectopic symptoms? correct answers Pain
Amenorrhea
Spotting or bleeding
What are the three categories of ectopic pregnancies? correct answers Intrauterine, extrauterine,
heterotopic
What are the treatment options for ectopic? correct answers Medical
Surgical
Expectant management
Which is preferable, medical or surgical management of ectopic? correct answers Medical
management is preferable to even "conservative" surgical procedures whenever feasible, esp in
asymptomatic women with early unruptured EP
In what location might an intrauterine ectopic occur? correct answers Gestation in cervix or
cornua
In what location might an extrauterine ectopic occur? correct answers Fallopian tube, ovary,
abdomen, broad ligament
In what location might an heterotopic pregnancy occur? correct answers Implantation in both
uterine cavity and in an ectopic site (usually tube)
When are heterotopic pregnancies more likely? correct answers With pregnancy resulting from
IVF
Which type of ectopic is most common? correct answers Tubal (97%)
How are tubal ectopics classified? correct answers By location: ampullary, isthmic, fimbrial,
cornual/insterstital
What type of tubal ectopic is most common? correct answers Ampullary
Why is ampullary ectopic so common? correct answers Because it is where fertilization usually
occurs
When will a woman with an isthmic ectopic become symptomatic? correct answers Earlier rather
than later (6-7w?)
, Why will a woman with an isthmic ectopic become symptomatic earlier? correct answers
Because it that part of the tube is so narrow
What is the most distal part of the fallopian tube? correct answers Fimbriae
What can happen to the products of conception in a fimbrial ectopic? correct answers They can
be expelled into the peritoneal cavity
Why do interstitial ectopics generally rupture later rather than earlier? correct answers Thicker
portion of the tube partially surrounded by myometrium
When would rupture generally occur with an interstitial ectopic? correct answers 9-12w
What is a possible etiology of ectopic related to implantation? correct answers Mechanical
interference with implantation: IUC, hormonal dysfunction, sterilization failure
What are some factors considered high risk for ectopic? correct answers Prior ectopic pregnancy
Tubal pathology & surgery
In utero DES exposure
What is the chance of recurrence with prior ectopic pregnancy? correct answers 33%
What kind of infection can result in tubal pathology? correct answers Chlamydia, GC,
polymicrobial
What is the relationship between IUDs and ectopic? correct answers Doesn't cause EP but if a
pregnancy occurs there's a greater risk that the pregnancy is EP
What type of infertility is of greatest risk for ectopic? correct answers Patients with primary
infertility due to tubal factors that prohibit or delay ovum transport
What are some surgical risk factors for ectopic? correct answers History of pelvic or abdominal
procedures
What lifestyle factor is known to increase risk of ectopic? correct answers Smoking (dose
dependent), multiple partners, early age of 1st intercourse
What percentage of women with ectopic will have NO identifiable risk factors or initial
definitive physical findings? correct answers 50%
What kind of pain is associated with ectopic? correct answers Abdominal usually monitor pelvic,
shoulder
What kind of pain suggests rupture? correct answers Sharp, sudden, stabbing
What might exacerbate abdominal pain due to ectopic? correct answers Movement
