Flashcards in Ectopic Pregnancy Deck (72)
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61
What is the usual procedure for a tubal ectopic?
Laparoscopic salpingectomy
62
What happens in a laparoscopic salpingectomy for tubal ectopic?
Removal of the tube the fetus is implanted in
63
If there is damage to the contralateral tube what alternative procedure can be considered to preserve fertility?
Salpingotomy
64
What follow-up is require in a salpingotomy for ectopic pregnancy?
HCG testing until <5iU
65
What happens to the risk of future ectopic pregnancy in the tube that underwent salpingotomy?
Increase
66
When is surgical management of ectopic pregnancy considered?
- Severe pain
- Serum beta-hCG >5000mlU/ml
- Adnexal mass >34mm
- Visible fetal heart beat
67
What are the advantages of surgical management of ectopic pregnancy?
- Reassurance of definitive treatment
- High success rate
68
What are the disadvantages of surgical management of ectopic pregnancy?
- GA risk
- Risk of damaging neighbouring structures
- Risk of treatment failure with salpingotomy
69
What structures are at risk in surgical management of ectopic pregnancy?
- Bladder
- Bowel
- Ureters
- DVT/PE
- Haemorrhage
- Infection
70
Why may a salpingotomy fail at treating ectopic pregnancy?
Some pregnancy may remain
71
What should all Rh -ve women receive before surgical management of ectopic pregnancy?
Anti-D prophylaxis
72
