Ectopic Pregnancy

Ectopic Pregnancy from Sun YaiCheng

Ectopic  Pregnancy
N Engl J Med 2009;361:379-87

Ultrasonographic Examination

In gestations longer than 5.5 weeks, a transvaginal ultrasonographic examination should identify an intrauterine pregnancy with almost 100% accuracy.

Ultrasonographic Findings in  Ectopic Pregnancy

Change in the hCG Level in Intrauterine Pregnancy, Ectopic Pregnancy, and Spontaneous Abortion

Correlation of Ultrasonographic Findings with hCG Values  

“Discriminatory hCG value”   1500—3000 mIU/ml

the sensitivity of ultrasonography for the detection of intrauterine pregnancy approaches 100% and at which the absence of an intrauterine pregnancy suggests abnormal or ectopic gestation.

Management

Surgical Management

• Salpingectomy or Salpingostomy

Medical Management

• Intramuscular administration of the Methotrexate
• single-dose or multidose regimen

九十八年  急專考題

有關子宮外孕的臨床特性及診斷，下列敘述何者錯誤？

(A) 危險因子包括曾經發生子宮外孕、輸卵管結紮、人工受孕、和骨盆腔發炎的病史。
(B) 典型的症狀是腹痛、陰道出血、及無月經。
(C) 若尿液懷孕測試陰性就能排除子宮外孕。  X
(D) 病人可能發生危及生命的休克症狀。
(E) 腹痛或腹部不適是最常見的症狀，一般而言是突然的單側劇烈疼痛