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Anatomy

Abdomen

Question 19 of 77

A patient is sent in by her GP with suspected ectopic pregnancy. Tubal ectopic pregnancies occur most commonly in which part of the uterine tube:

Answer:

Ectopic pregnancy most commonly occurs in the ampulla (70% of cases).

Superiorly, uterine tubes project laterally from the uterus, extending to the lateral pelvic wall, passing superior to the ovaries and opening into the peritoneal cavity immediately lateral to the ovaries.

Modified by FRCEM Success. Original by Blausen.com staff. "Blausen gallery 2014". Wikiversity Journal of Medicine. DOI:10.15347/wjm/2014.010. ISSN 20018762. (Own work) [CC BY 3.0 , via Wikimedia Commons

Uterine Tubes. (Image modified by FRCEM Success. Original by Blausen.com staff. “Blausen gallery 2014”. Wikiversity Journal of Medicine. DOI:10.15347/wjm/2014.010. ISSN 20018762. (Own work) [CC BY 3.0 , via Wikimedia Commons)

Divisions

Each uterine tube is approximately 10 - 12 cm long and has:

  • fimbriae (finger-like ciliated projections)
  • an infundibulum, (the funnel-shaped opening which curves around the superolateral pole of the ovary and opens into the peritoneal cavity)
  • an ampulla (the elongated middle part)
  • an isthmus (the narrow proximal end which joins the body of the uterus).

Ectopic pregnancy most commonly occurs in the ampulla (70% of cases).

Site of Ectopic Pregnancy. (Image by BruceBlaus [CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0)], from Wikimedia Commons)

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  • Biochemistry
  • Blood Gases
  • Haematology
Biochemistry Normal Value
Sodium 135 – 145 mmol/l
Potassium 3.0 – 4.5 mmol/l
Urea 2.5 – 7.5 mmol/l
Glucose 3.5 – 5.0 mmol/l
Creatinine 35 – 135 μmol/l
Alanine Aminotransferase (ALT) 5 – 35 U/l
Gamma-glutamyl Transferase (GGT) < 65 U/l
Alkaline Phosphatase (ALP) 30 – 135 U/l
Aspartate Aminotransferase (AST) < 40 U/l
Total Protein 60 – 80 g/l
Albumin 35 – 50 g/l
Globulin 2.4 – 3.5 g/dl
Amylase < 70 U/l
Total Bilirubin 3 – 17 μmol/l
Calcium 2.1 – 2.5 mmol/l
Chloride 95 – 105 mmol/l
Phosphate 0.8 – 1.4 mmol/l
Haematology Normal Value
Haemoglobin 11.5 – 16.6 g/dl
White Blood Cells 4.0 – 11.0 x 109/l
Platelets 150 – 450 x 109/l
MCV 80 – 96 fl
MCHC 32 – 36 g/dl
Neutrophils 2.0 – 7.5 x 109/l
Lymphocytes 1.5 – 4.0 x 109/l
Monocytes 0.3 – 1.0 x 109/l
Eosinophils 0.1 – 0.5 x 109/l
Basophils < 0.2 x 109/l
Reticulocytes < 2%
Haematocrit 0.35 – 0.49
Red Cell Distribution Width 11 – 15%
Blood Gases Normal Value
pH 7.35 – 7.45
pO2 11 – 14 kPa
pCO2 4.5 – 6.0 kPa
Base Excess -2 – +2 mmol/l
Bicarbonate 24 – 30 mmol/l
Lactate < 2 mmol/l
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