Module 7: Ectopic Pregnancy & Postpartum Uterus

right before ovulation, what should a mature follicle measure

2 cm (20mm)

in a normal, healthy patient, what does free fluid in the cul-de-sac region indicate

ovulation (they have just ovulated or are currently ovulating)

how often do hCG levels double

every 24-48 hours

what are some signs/symptoms of a tubal rupture

-bleeding

-dizziness/lethargy

-right shoulder pain

an increased risk of hemorrhage is consistent with _________ ectopic pregnancy

interstitial

what type of ectopic pregnancy is related to a c-section scar & may be cause for a complete hysterectomy

intramural

given ultrasound findings and beta hCG levels, what are possible next steps in caring for the patient

-watch & wait (beta hCG is lower, decreasing)

-IM injection (beta hCG rising abnormally slow)

-surgical intervention can also be done

methotrexate (IM injections) can only be used for sacs up to ______ as the greatest diameter

3.5-4cm

beta hCG should be less than _________ & __________ should be absent to use methotrexate/IM injections

5000; fetal heartbeat

if the patient is hemodynamically unstable, what treatment option should be done for an ectopic pregnancy

surgical intervention

if the patient is hemodynamically stable, what treatment option should be done for an ectopic pregnancy

methotrexate/IM injections

when trying to preserve fertility, what surgical intervention is used

salpingotomy (open tube and remove pregnancy without removing tube)

abnormal fetal heart rate for a 6 weeker is ...

under 110bpm

the primary yolk sac contributes to the embryo how

-provides embryo with nourishment

-helps circulate gasses between the mother & embryo

-produces cells that turn into vital structures (umbilical cord, blood cells, reproductive organs)

what is the discriminatory cutoff level

1000

what is a tubal resection

surgical intervention to remove part of the tube

what is the success rate for expectant management (watch & wait) treatment for ectopic pregnancies

7-40%

what factors would increase the success rate for expectant management (watch & wait) treatment for ectopic pregnancy

-lower, decreasing beta hCG levels

-no gestational sac seen