Ectopic Pregnancy

If a patient comes in with abdominal pain in the 1st trimester, what is your priority intervention?

ULTRASOUND!!

What is an ectopic pregnancy?

The fertilized egg implants outside of the uterus in the fallopian tube

S/S of ectopic pregnancy

• Unilateral pain

• Vaginal Bleeding (rupture)

  • Hypotension & Tachycardic

• Missed Period

• Tenderness

• Palpable mass

Risk factors for ectopic pregnacy

STI

Hx of ectopic

Previous tubal, pelvic, or abdominal surgery

Endometriosis/PCOS

Estrogen & Progesterone

IVF

DES exposure

Hallmark sign of ectopic pregnancy

unilateral stabbing pain in the lower quadrant (fallopian tube)

What to ask a patient with abdominal pain in the 1st trimester?

“Have you had an ultrasound yet?”

If yes,

“Was the baby where it is supposed to be?”

Why is an ectopic pregnancy a medical emergency?

It could rupture

What complication could occur with rupture?

Internal Hemorrhage

• Blood loss, shock, death

What to monitor in regards to internal hemorrhage (VS)

High HR

Low BP

feeling faint/dizzy

Tx of Ectopic pregnancy

Surgery!!

May need hysterectomy

What is a Salpingectomy?

Removal of ruptured fallopian tubes

What drug can be given to treat?

Methotrexate

• Chemotherapeutic & folic acid inhibitor

• Used for uncomplicated, non-life-threatening ectopic pregnancies

Methotrexate pt Education

• Side effects

  • N/V

• D/C prenatals

• X Alchohol & NSAIDS

• Wear sunscreen