Ectopic pregnancy

Not true of ectopic gestation is

A. Ampullary tubal implantation is the commonest site
B. Majority of abdominal pregnancies are extraperitoneal
C. Tubal plastic operations increases the risk
D. Incidences have increased but mortality is reduced

Which of the following indicates incorrect cause and effect relationship in ectopic pregnancy

A. IUD prevents intrauterine pregnancy hence tubal implantation is a risk
B. Progestin only pill increases the chance of tubal pregnancy by angiogenesis within the fallopian tube
C. Chlamydia trachomatis infection results in the production of interleukin 1 and hence ectopic implantation
D. Cilia beat frequency is negatively affected by smoking and increases risk of ectopic pregnancy

Not true of Interstitial ectopic pregnancies is

A. Reported in up to 4% of all ectopic implantation sites
B. Mortality rates are least among other ectopic implantation sites
C. The condition is difficult to diagnose sonographically
D. Hysterectomy rates are as high as 40%

All are correct of ectopic implantation except

A. Intraepithelial implantation occurs in cases of tubal ectopic
B. Secondary broad ligament pregnancy occurs between two layers of the peritoneum
C. ‘Sliding sign’ on transvaginal ultrasound can differentiate cervical pregnancy
D. Decidual change at the site of implantation is minimal in tubal ectopic

Not a fate of tubal ectopic pregnancy is

A. Complete absorption
B. Complete abortion
C. Tubal rupture
D. Continuation of pregnancy

Not a feature of chronic ectopic

A. Expulsion of decidual cast
B. Cullen‘s sign
C. Features of shock
D. Retention of urine

In short

  • In interstitial pregnancy the general condition is low hence often, a quick subtotal hysterectomy is done.

  • Oophorectomy is rarely done if the ovary is damaged beyond repair.

  • Serum progesterone greater than 25 ng/mL is suggestive of viable intrauterine pregnancy whereas level less than 5 ng/mL suggests an ectopic or abnormal intrauterine pregnancy.

  • Chorionic villi that float in normal saline as lacy fronds are diagnostic of intrauterine pregnancy.

  • When the β-hCG value is greater than 1,500 IU/L and there is an empty uterine cavity, ectopic pregnancy is more likely.

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