Review Note
Last Update: 03/02/2025 10:09 AM
Current Deck: ACG Part 2::Obstetrics
New Card (Unpublished)Currently Published Content
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Commit #292868SS_OB 1.19 Describe the anaesthetic management of early pregnancy conditions such as ectopic pregnancy
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Commit #292868- Major comorbidity associated with ectopic pregnancy: death, infertility, recurrent ectopic pregnancy
- Risk factors:
- Prior ectopic
- Prior tubal surgery
- PID
- Congenital anatomic distortion
- Previous pelvic/abdominal surgery
- Use of intra-uterine device
- Delayed ovulation
- Progesterone only OCP
- Smoking
- Assisted reproductive procedures
- Two main presentations: Stable and emergency rupture
- Stable:
- Often can await diagnosis of serial bHCG’s and USS
- May have expectant management if asymptomatic and early diagnosis (50% spontaneously resolve)
- Medical management: Methotrexate
- Surgical: Laparoscopic surgery - salpingostomy, salpingotomy, salpingectomy
- GA + ETT, wide bore IVL as risk of rupture and bleeding
- Emergency (15%) of cases:
- Present with fallopian tube rupture and arterial bleeding
- Need resus and urgent transfer to OT
- 2x wide bore IVL’s, G&H
- RSI + ETT
- Consider cell salvage and rapid infusor + A-line and CVL in haemodynamic instability
- Temperature monitoring, fluid warmer, forced air warmed
- Surgical: Lap vs open laparotomy