Ectopic Pregnancy

Question 1

What is an Ectopic Pregnancy?

Answer 1

An ectopic pregnancy is when a fertilised egg implants itself outside the womb, usually in the fallopian tubes

Question 2

Causes of an Ectopic Pregnancy

Answer 2

• Hormonal factors
• Damaged fallopian tubes
• Genetics
• Abnormal development of fallopian tubes or other reproductive organs

Question 3

Risk Factors for an Ectopic Pregnancy

Answer 3

• Previous ectopic’s
• STI’s
• Undergoing fertility treatment
• Smoking

Question 4

Signs and Symptoms of Developing/Ectopic Pregnancy

Answer 4

• Abnormal PV bleeding -
• Lower abdo pain - gradually/suddenly
• Shoulder tip pain - due to internal bleeding
• Pain or pressure when opening bowels/urinating, diarrhoea
• Missed period
• Pale complexion/pallor
• Signs of developing peritonism

Question 5

Signs and Symptoms of Ruptured Ectopic

Answer 5

• Sharp and sudden, intense abdo pain
• Feeling dizzy/fainting
• Nausea
• Pallor, clamminess
• Signs of hypovolaemic shock (tachy, hypotensive)
• Rebound tenderness
• Rigid, tender abdomen with guarding

Question 6

Fluid Replacement in Ectopics

Answer 6

If the patient is less than 100 systolic, they will require fluid replacement therapy

Question 7

Hospital Treatment for Ectopics

Answer 7

• Emotional support
• Expectant management - pregnancy wont come to term
• Surgery - keyhole surgery to remove the egg. They will either leave or remove the fallopian tube
• Methotrexate Injections - blocks enzymes that maintain pregnancy, stops the tissue from growing bigger to prevent rupture

Question 8

List of Differentials for Ectopic Pregnancy

Answer 8

• Misscarraige
• Pelvic Inflammatory Disease
• Endometriosis
• Ovarian Torsion
• Appendicitis
• Gastroenteritis
• UTI’s