GYNAECOLOGY

ECTOPIC PREGNANCY

Introduction

5 min

Introduce yourself and the group

Provide rationale for the session and relevance to clinical practice

Outline learning objectives:

Take a focused gynaecology history from a patient presenting with a probable ectopic pregnancy and consider suitable differential diagnosis
Suggest and interpret the key findings of investigations in diagnosis of ectopic pregnancy
Understand the management of an ectopic pregnancy
List complications of an ectopic pregnancy

Explain structure of session

Total time:

60 min

Number of students:

1-5

Grade of students:

3rd to 5th year medical students

Created by:

Dr Rachel Cooke

Uploaded:

26th September 2019

Last updated:

26th September 2019

Resources needed for this session:

Students can scan the QR code opposite to view all investigation results on their phone as you work through the session.

Resources linked to this session:

Activity 1: History Taking and Examination Skills

20 min

Ask the student(s) to take a focused history from a patient(s) including a gynaecology history. This could be observed if capacity allows. If appropriate, ask the student(s) to undertake an appropriate clinical examination.

In many cases this may not be possible or appropriate, in which case, discuss signs of an ectopic pregnancy during later activities.

Activity 2: Diagnostic Reasoning

10 min

Discussion and feedback. Ask the student(s) to present the key findings of the case. Feedback on presentration style (max 1 min).

Discuss:

What differential diagnoses have they considered and why are these less likely?
What are the risk factors for ectopic pregnancy?
What investigations would be useful in the acute presentation?

Activity 3: Investigations

5 min

Ask student(s) to suggest appropriate blood tests for a patient with a suspected ectopic pregnancy. If possible, review the patient's blood results with the student.

Discuss the role of beta-hCG in ectopic pregnancy.

Activity 4: Imaging

5 min

Discuss the role of transvaginal USS in a patient with a suspected ectopic pregnancy.

What are the key structures that may be seen?
What abnormalities are we trying to identify?

Using the patient's investigation results, if possible, or the example below:

Ask the student(s) to identify key anatomy.
Are any abnormalities evident?

Discuss and identify abnormalities – students may have limited experience of looking at transvaginal USS images so may need orientating to basic anatomy.