Ectopic Pregnancy

Blue arrow - Uterus
Red arrow - Left fallopian tube with Ectopic Pregnancy

Risk factors :-
• H/o previous Ectopic pregnancies.
• Ovulation induction using clomiphene
• Pelvic Inflammatory Disease (Most Common)
• After tubal injury (Max risk)

Triad :- ABP NEWS
• Amenorrhea
• Vaginal Bleeding
• Abdominal pain
• Others - Nausea, Vomiting, Syncope

Examination :-
• Cullen's sign - Bluish discoloration around umbilicus.
• Blanched vaginal mucosa
• Pelvic tenderness
• Pelvic mass
• Culdocentesis (Fluid aspiration from cul-de-sac via posterior fornix) - Non clotting blood obtained is indicative of ruptured ectopic.

Imp points :-
• Decidual cast is pathognomic of Ectopic Pregnancy.
• Chorionic villi are absent in decidua
• MC site of Ectopic pregnancy - Fallopian tubes

Diagnosis :-
• beta HCG
• USG - Bagel Sign / Tubal Ring sign.
• Doppler sonography - Ring of fire.

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Bagel Sign

T/t :-
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• Methotrexate (DOC)
• Prostaglandin
• Hyperosmolar Glucose
• Mifepristone
• Actinomycin D
• Vasopressin
• KCl

Conservative Sx - Salpingostomy
Radical Sx - Salpingectomy