4- Ectopic Pregnancy

Ectopic pregnancy refers to a pregnancy that occurs __________.

outside the uterine cavity.

The incidence of ectopic pregnancy is approximately __________ of all first-trimester pregnancies.

2%.

The most common implantation site for ectopic pregnancies is the __________.

fallopian tube.

The key risk factor for repeat ectopic pregnancy is a history of __________ ectopic pregnancies.

In a case of heterotopic pregnancy, an ectopic pregnancy can co-occur with __________ pregnancy.

intrauterine.

The primary method for diagnosing an ectopic pregnancy is __________ ultrasound.

transvaginal.

A gestational sac with yolk sac or embryo located outside the uterus is a definitive sign of __________ pregnancy.

ectopic.

If there is visualization of an intrauterine pregnancy, it __________ eliminate the possibility of an ectopic pregnancy.

does not.

The measurement of serum human chorionic gonadotropin (hCG) should not be used __________ to diagnose an ectopic pregnancy.

alone.

An hCG level above __________ indicates that a gestational sac must be visible on transvaginal ultrasound.

1500-2000.

A single hCG measurement cannot establish the __________ or location of a gestation.

viability.

In normal pregnancies, the hCG level typically __________ every 48 hours.

doubles.

Methotrexate is a folate antagonist used in the treatment of __________ pregnancy.

ectopic.

Absolute contraindications for methotrexate treatment include evidence of __________ pregnancy.

intrauterine.

After methotrexate administration, hCG levels should be monitored until a __________ level is reached.

nonpregnancy.

The most common adverse effects of systemic methotrexate include nausea, vomiting, and __________.

stomatitis.

Patients treated with methotrexate should be counseled about the risk of ectopic pregnancy __________.

rupture.

In patients with a ruptured ectopic pregnancy, signs of __________ may be present.

intraperitoneal bleeding.

Salpingectomy involves the removal of a part or all of the __________ tube.

fallopian.

Salpingostomy is the removal of the ectopic pregnancy while leaving the __________ tube.

fallopian.

When there is severe fallopian tube damage, __________ is preferred.

salpingectomy.

Post-surgical management includes monitoring hCG levels to ensure the resolution of __________ pregnancy.

ectopic.

In women who are clinically stable with a nonruptured ectopic pregnancy, both laparoscopic surgery and __________ administration are safe treatments.

methotrexate.

Failure of the hCG level to decrease by at least __________ from day 4 to day 7 after methotrexate administration indicates a high risk of treatment failure.

15%.

Patients can be counseled that methotrexate does not have an adverse effect on subsequent __________ or on ovarian reserve.

fertility.

Medical management of ectopic pregnancy includes the use of __________.

methotrexate.

Intrauterine gestational sacs should be visible between __________ weeks of gestation.

5 and 6.

The risk factors for ectopic pregnancy include previous ectopic pregnancy, PID, __________, and smoking.

IVF.

Transvaginal ultrasound finding suspicious for ectopic pregnancy typically shows a mass with a __________ area separate from the ovary.

hypoechoic.

Patients should avoid __________ that may mask symptoms of rupture after MTX treatment.

analgesics.

An hCG value of 4000 mlU/ml without a visible intrauterine gestational sac suggests the possibility of __________ pregnancy.

ectopic.

The treatment approach for ectopic pregnancy depends on __________.

patient's clinical status.

The incidence of ectopic pregnancy in ovaries is __________.

1-3%.

Ectopic pregnancy can also occur in the __________.

cervix.

The rate of recurrence for ectopic pregnancy rises to over __________% with two or more prior ectopic pregnancies.

Medical treatment for ectopic pregnancies was first introduced in __________.

Methotrexate works by inhibiting DNA synthesis and repair of __________ tissues.

cell proliferating.

Relative contraindications for methotrexate treatment include detection of __________ cardiac activity.

embryonic.

Monitoring hCG levels after surgical management is important especially for __________ procedures.

salpingostomy.

Patients treated with methotrexate should delay conception for at least __________ months after treatment.

The first step in diagnosing ectopic pregnancy is often through the use of __________ tests.

lab.

The identification of a pseudogestational sac indicates a potential __________ in ectopic pregnancy.

misdiagnosis.

If hCG levels decrease more slowly than expected, it suggests an __________ pregnancy.

ectopic.

After methotrexate treatment, hCG levels may initially increase before they begin to __________.

decrease.

Women should be advised to seek medical attention at the onset of __________ after treatment with methotrexate.

abdominal pain.

Abdominal pain following methotrexate administration is presumed to stem from the drug's effect on __________ tissue.

trophoblastic.

Common signs of ectopic pregnancy rupture include significant __________ pain.

abdominal.

The primary method of monitoring after methotrexate therapy is through __________ of hCG levels.

serial measurement.

Surgical candidates for ectopic pregnancy include those who are hemodynamically __________.

unstable.

When discussing treatment options, it is important to consider each patient’s __________ for future fertility.

desire.

Surgical management is required when there are signs of __________ bleeding.

intraperitoneal.

Ectopic pregnancies can be diagnosed through clinical findings and __________ data.

ultrasound.

The __________ is a collection of fluid or blood in the uterine cavity that can mimic a gestational sac.

pseudosac.

Ectopic pregnancy can be caused by damage to the __________ tubes.

fallopian.

The likelihood of establishing a successful pregnancy after ectopic pregnancy treatment depends on the extent of __________ damage.

fallopian tube.

Intrauterine pregnancies can obscure the diagnosis of an __________ pregnancy.

ectopic.

The decision for medical vs. surgical management is based on clinical evaluation of the patient’s __________.

stability.

Patients can be counseled regarding the importance of follow-up and the need to monitor for further __________ post-treatment.

complications.

The process of tissue __________ is affected by methotrexate, particularly in rapidly dividing tissues.

repair.

An absolute contraindication for methotrexate treatment includes active __________ disease.

pulmonary.

Counseling patients about methotrexate treatment should include information about the potential for treatment __________.

failure.

Post-treatment assessment involves checking if hCG levels return to __________ levels.

nonpregnancy.