SAQ 151 – Obstetrics – ectopic pregnancy

Question 3. ectopic pregnancy.

a. Risk factors

• Previous ectopic pregnancy.
• IVF.
• PID.
• Tubal surgery or manipulation.
• OCP.
• IUD.
• Increasing age.

b. Examination findings

• Pregnancy with shock or haemodynamic instability.
• Pregnancy with adnexal tenderness on PV examination.
• Pregnancy with iliac fossa tenderness.
• Pregnancy with cervical excitation.
• Pregnancy with signs of peritonism.

c. Ultrasound findings

• Gestational sac identified extrauterine.
• Absence of intrauterine pregnancy on TVUS if beta-hCG >1500, or transabdominal ultrasound if >5000.
• Free fluid in the pouch of Douglas.
• Free fluid surrounding fallopian tube.
• Haemosalpinx.
• Extrauterine mass.
• Adnexal mass.