CHAPTER 19: Ectopic Pregnancy

Ectopic Pregnancy

What percentage of first-trimester pregnancies in the United States are ectopically located?

a. 0.1–0.5%

b. 0.2–1.0%

c. 0.5–1.5%

d. 1.0–2.0%

c Introduction

A 25-year-old nulligravida with Rh-negative blood type and a negative antibody screen is postoperative day 1 following salpingectomy for a 6-week ectopic pregnancy. What dose of IgG anti-D immunoglobulin is deemed sufficient prior to discharge?

a. 50 µg

b. 100 µg

c. 200 µg

d. 300 µg

a Classification

Among women who become pregnant while using contraception, the relative number of ectopic pregnancies is increased with which of the following contraceptives?

a. Condoms

b. NuvaRing

c. Progestin-releasing intrauterine device

d. Estrogen-containing birth control pills

c Risks

A 31-year-old G2P1 presents to the emergency room at 7 weeks by last menstrual period with pelvic pain. Her β-hCG level is 1234 mIU/mL, but no ultrasound is performed. When she returns to her obstetrician’s office for follow-up 3 days later, her β-hCG is 1166 mIU/mL and ultrasound demonstrates a 5-cm complex left adnexal mass. A diagnostic laparoscopy is performed, and the surgical findings are shown in the image. What is the most likely diagnosis?

a. Paratubal cyst

b. Serous cystadenoma

c. “Acute” ectopic pregnancy

d. “Chronic” ectopic pregnancy

d Evolution and Potential Outcomes

In ectopic pregnancies, the absence of which tubal tissue layer facilitates rapid invasion of proliferating trophoblasts into the muscularis?

a. Serosa

b. Epithelium

c. Submucosa

d. Connective tissue

c Evolution and Potential Outcomes

What is the classic triad of clinical symptoms of an ectopic pregnancy?