Ectopic Pregnancy

First Trimester ComplicationsFetal Biometry WorkshopDay 11ObjectivesReview presentation , consequences & sonographic findings of ectopic pregnancyDiscuss different types of abortionDefine Blighted OvumReview different types of molar pregnancyIdentify coexisting maternal pelvic masses

36 12 weeks = embryonic period

5.5 weeks endovaginal detection 2 mmFetal heart motion 5.3 5.5 weeksFetal heart is first organ to function with development completed by end of 8th weekEmbryo initially seen as a thin linear structure adjacent to yolk sacOrganogenesis is complete @ approximately 10 weeks gestational age

A Teratogen = any agent that causes a structural abnormality following fetal exposure during pregnancy. The overall effect depends on dosage and time of exposure.

Absolute risk - the rate of occurrence of an abnormal phenotype among individuals exposed to the agent. (e.g. fetal alcohol syndrome)

Relative risk - the ratio of the rate of the condition among the exposed and the nonexposed. (e.g. smokers risk of having a low birth weight baby compared to non-smokers)A high relative risk may indicate a low absolute risk if the condition is rare.

First trimester 5.5 weeks = small fetal pole with beating fetal heart

Tubal ImplantationAbnormal tubesCongenitalPID***Tubal Surgery

Normal tubesTransmigration of ovumEmbryonic abnormalitiesHormonal imbalancePelvic massesIUDReduced tubal motility

Tubal ImplantationHormonal ImbalanceEstrogenProgesterone

Tubal Implantation MechanicalDevelopmental anomaliesInfectious damageTubal surgery

Interstitial Implantation

9Interstitial ectopic pregnancy. Coronal sonogram through the right cornu of the uterus shows the endometrium (arrowheads) extending into a inhomogeneous mass (M).

Abdominal Implantation PrimaryNormal tubes & ovariesSecondaryTubal abortion with extension into peritoneal surface

Ovarian Implantation Rare