Ectopic Pregnancy

Question 1

At what hCG level can an intrauterine pregnancy be seen?

Answer 1

2000

Question 2

What do you do in a stable patient with suspected ectopic pregnancy with a hCG level of 1000?

Answer 2

Repeat hCG in 48 hours. If hCG is >2000 and no IUP is visible, treat with methotrexate.

If unstable–> Surgery

Question 3

How much should hCG rise in 48 hours?

Answer 3

more than 50%. hCG should double every 2-3 days.

If hCG inc is inapproprirate, suspect ectopic pregnancy.

Question 4

What is the biggest risk factor for ectopic pregnancy?

Answer 4

Prior ectopic pregnancy

Question 5

What level of progesterone suggests normal pregnancy?

Answer 5

> 25

Question 6

How do you treat a non viable IUP?

Answer 6

Expectant management and/or Mifepristone

Question 7

What are the indications for methotrexate in ectopic pregnancy?

Answer 7

Hemodynamic stability
Non-ruptured pregnancy
<4cm w/o heart rate
<3.5cm w/heart rate
Normal labs